Prior Authorization Coordinator

Auxiant•Cedar Rapids, IA

About The Position

Auxiant’s Mission Statement and Core Values Mission: An Independent TPA investing in People and Innovation to deliver expert-driven experiences with REAL Results. Core Values: Independent Solutions. REAL Results Respect Empowerment Agility Leadership Be part of a growing and prospering company as a Prior Authorization Coordinator. Auxiant is a third party administrator of self-funded employee benefit plans with offices in Cedar Rapids, IA, Madison and Milwaukee, WI. Auxiant is a fast-growing,progressive company offering an excellent wage and benefit package. Job Summary: The Prior Authorization Coordinator is responsible for the handling and tracking of medical necessity review requests received.

Requirements

Understanding of medical terminology
Familiarity with ICD10 and HCPCS/CPT codes
1+ year data entry experience and QicLink experience
Proficient PC skills including e-mail, record keeping, routine database activity, word processing, spreadsheet,10-key
Proven experience in a professional office environment
High school diploma and 1-2 years related experience; or equivalent combination of education and experience.

Nice To Haves

1+ year medical experience preferred

Responsibilities

Review plan document language to determine if a requested service is eligible under the health plan
Forward documentation to the appropriate vendor for medical necessity review
Draft and send response letters based on interpreting medical necessity determination received from outside vendor
Track medical necessity reviews internally and by using vendor portals
Run and review various reporting
Assist with department questions
Review Single Case Agreement requests
Other duties as assigned or appropriate