Diverse Lynx · 11 hours ago
Benefits Coordinator / Referral Coordinator / Pre Authorization Specialist / Prior Authorization Specialist / Authorization Coordinator
United States
Full-time
Remote
Entry Level
$17/hr - $17/hr
2+ years expDiverse Lynx is seeking a Prior Authorization Specialist to support clinicians by verifying authorization or referral and documenting findings. The role involves determining if prior authorization is required and managing cases while meeting production and quality expectations.
Information Technology & Services
Responsibilities
This is a production role and you will have the responsibility to meet production, quality and regulatory expectations
Ensure case is set up correctly and document required information
Review, research and determine if case can be decisioned or if it requires additional clinical review
Demonstrate proficiency and decision making by solving complex problems using available resources (documents, medical policy, standard operating procedure, etc.)
As needed, make outbound calls to providers and/or members to obtain information regarding a case
As needed, make outbound calls to providers to coordinate provider availability in treating members
Other duties as assigned by manager and/or director
Qualification
Required
High School or equivalent - Document will be required so have a hard copy available
2 + Year of WFH experience with High-speed internet
2+ Year previous experience working with back office medical platforms and/or authorizations systems
2+ Year of experience working within the Healthcare Industry, Hospital, Physician's Office, or Medical Clinical setting, Medical Terminology, ICD-10 and CPT codes, Medicare and/or Medicaid Service
Professional experience in a Clerical or Administrative support related role
Able to quickly learn various computer systems or applications
Computer/ Laptop experience and can navigate Outlook, share screen in TEAMS, skill with Word & Excel spreadsheets
Preferred
Previous experience working with back office medical platforms and/or authorizations systems
Experience working within the Healthcare Industry, Hospital, Physician's Office, or Medical Clinical setting, Medical Terminology, ICD-10 and CPT codes, Medicare and/or Medicaid Services
Professional experience in a Clerical or Administrative support related role
Able to quickly learn various computer systems or applications
Benefits
Benefits ( Day 1 )
Company
Diverse Lynx
Diverse Lynx is a WBENC- and NMSDC-certified partner, helping organizations turn diversity goals into measurable impact through staffing and contingent workforce solutions.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Sujata Varma
CEO
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