Prior Authorization Specialist

Mahec•Asheville, NC

1d•Onsite

About The Position

This position will be responsible for requesting prior authorizations for services provided at MAHEC and services referred outside of MAHEC Service Lines. This includes obtaining and requesting prior authorizations for in-house procedures, Medicare HMO visits, radiology, and behavioral health. The specialist will partner with clinics and the referrals team to acquire necessary prior authorizations, ensuring approvals and working on any denials. The role may also involve supporting other areas needing prior authorizations and referrals, assisting with Peer-to-Peer requests and Appeals.

Requirements

Basic typing, Microsoft Office Suite (Outlook, Excel, Word, PPT), Data Entry.
Some college and/or equivalent experience in the healthcare field such as Prior Authorization Experience, experience in Human Services or Healthcare Administration, with a focus on Utilization Review.

Nice To Haves

Allscripts EHR experience.
Foreign Language Fluency in Spanish.
Previous experience in prior authorizations.

Responsibilities

Obtaining and requesting prior authorizations for in-house procedures, Medicare HMO visits, radiology, and behavioral health.
Partnering with clinics and the referrals team to acquire necessary prior authorizations.
Ensuring authorizations are approved and working on any denials.
Assisting with any Peer-to-Peer requests and Appeals.
Supporting other areas needing prior authorizations and referrals.