MotivHealth ยท 11 hours ago
Pre-Authorization Specialist
South Jordan, Utah, United States
Full-time
Hybrid
Entry, Mid Level
2+ years expMotivHealth is a dynamic and mission-driven health insurance company dedicated to disrupting the status quo by making healthcare simpler and more affordable for our members. The Pre-Authorization Specialist plays a critical role in ensuring that medical services requiring prior approval are reviewed, processed, and documented accurately and efficiently, serving as a liaison between providers, members, and internal teams.
Health CareInsurance
Responsibilities
Review and prepare pre-authorization letters for accuracy and send them to the requesting provider
Provide exemplary customer service by answering calls and voice messages from physician offices, hospitals, and members
Accurately enter required information into the pre-authorization system
Review structured clinical data and ensure compliance with specified medical terms and codes for final authorization
Receive, review, and process incoming pre-authorization requests from providers, facilities, and members
Verify member eligibility, plan benefits, and applicable policy guidelines before initiating the authorization process
Ensure completeness and accuracy of all clinical documentation required for determination
Maintain compliance with HIPAA regulations, applicable laws, and internal policies
Adhere to turnaround time requirements for pre-authorization processing as outlined by regulatory bodies and client contracts
Document all interactions, determinations, and relevant notes in the utilization management system
Assist with audits and quality assurance reviews as needed
Qualification
Required
2 years of healthcare financial experience or equivalent and previous experience with medical insurance and prior authorizations
Familiarity with human anatomy, medical terminology, and ICD-10/CPT coding
Strong critical thinking and problem-solving abilities
Excellent professional verbal and written communication skills
Proficiency in Microsoft Word and spreadsheets
Capacity to work independently and within a team, adapting to dynamic environments
Demonstrated ability to prioritize tasks, manage heavy workloads, and multitask effectively
Benefits
Affordable health, vision, and dental insurance for you and your family
Company contributes up to $2,300 to Health Savings Account annually
Wellness program that contributes additional money towards your HSA
Automatic 3% contribution into retirement plan
Career development and growth opportunities
15 days of PTO & 10 paid holidays per year
Company
MotivHealth
MotivHealth is an insurance company which provides health insurance, hsa, hsa health insurance, and health savings account services.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Dave Hall
Executive Chariman
Recent News
2024-10-17
2024-04-05
Company data provided by crunchbase