Prior Authorization Coordinator at Auxiant

Madison, Wisconsin, United States -

Full Time

Start Date

Immediate

Expiry Date

21 Apr, 26

Salary

0.0

Posted On

21 Jan, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Terminology, ICD10 Codes, HCPCS Codes, CPT Codes, Data Entry, QicLink Experience, PC Skills, Record Keeping, Database Activity, Word Processing, Spreadsheet, 10-Key, Professional Office Experience

Industry

Insurance

Description

Description https://www.auxiant.com/ 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. Essential Functions: · 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 Nonessential Functions: · Other duties as assigned or appropriate Education/Qualifications: · Understanding of medical terminology · Familiarity with ICD10 and HCPCS/CPT codes · 1+ year medical experience preferred · 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. *Full benefits including: Medical, Dental, Vision, Flexible Spending, Gym Membership Reimbursement, Life Insurance, LTD, STD, 401K, 3 weeks vacation, 9 paid holidays, casual dress code and more Job Type: Full-time Schedule: 8 hour shift Day shift Monday to Friday

Responsibilities

The Prior Authorization Coordinator is responsible for handling and tracking medical necessity review requests. This includes reviewing plan documents, forwarding documentation for review, and drafting response letters based on determinations received.