Medical Prior Authorization Representative

Remote Full-time
Medical Prior Authorization Representative

Position: Medical Prior Authorization Representative (Temp to hire...
Pay: $17.50 per Hour
Location: Fully Remote
Start Date: 11/18
Shifts: You will be assigned shifts within the hours of 7 AM - 8 PM CST, M-F. You will be scheduled for an 8-hour shift within these hours.

This is a temp to hire role and a good way to get your foot in the door with an industry leader. You will be handling inbound calls from providers, members, pharmacies, etc. through the criteria based prior authorization process as well has conducting outbound calls. You will be assisting with Medicare Appeals processing as well. Your resume must show Prior Authorization and/or appeals to be considered. You must be comfortable on the phone; this is a high call volume position. Experience with Medicare D preferred.

Training Hours:
• 8-week training period
• Monday to Friday, 8 AM - 4:30 PM CST
• No time off allowed during training. Any vacations or time off must be discussed during the initial phone screen.

Responsibilities:
• Utilize multiple software systems to complete Medicare appeals case reviews
• Verifying insurance benefits
• Checking medication orders
• Convey resolution to beneficiaries or providers via direct communication and professional correspondence
• Process appeals
• Acquire and maintain basic knowledge of relevant and changing Med D guidance
• Meet or exceed government-mandated timelines
• Comply with turnaround time, productivity, and quality standards
• Ability to work in a fast paced environment

Requirements:
• High School Diploma or GED required
• Minimum of 1 year prior authorization and/or appeals experience (must be clearly listed on resume)
• Minimum of 1 year call center experience
• 6 months of prior remote experience strongly preferred
• Must be able to pass background and drug screen if selected for employment
• Must be organized and detail-oriented

Our Mission:

Choice One Staffing Group offers our employees assistance in finding the best positions for their skills, talents, and experience. It’s simple. At Choice One Staffing Group, People are our PURPOSE and YOUR success is OUR success!

Try us! You’ll find we focus on providing a positive candidate experience from your first contact through the completion of your first assignment and every assignment.

Employee Benefits:

We offer medical, holiday pay, vacation pay, referral bonuses and pre-employment preparation.

Specialized Staffing:

We specialize in Administrative, Light Industrial, Technical, Medical and Hospitality

EEO Policy:

Choice One Staffing Group, Inc. is an equal opportunity employer that prohibits employment discrimination based on race, color, religion, sex, national origin and ancestry, individuals who are 40 years of age and older or qualified individuals with disabilities.

Job Types: Full-time, Contract

Pay: $17.50 per hour

Benefits:
• Health insurance

Experience:
• prior authorization: 1 year (Required)
• call center: 1 year (Required)
• Medicare appeals: 1 year (Preferred)

Work Location: Remote

Apply Now

Apply Now →

Similar Jobs

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote

USPS Office Helper

Remote

Experienced Full Stack Customer Service Agent – Consumer Relations (Remote) at careerzynith

Remote

AI Conversational Bot Developer Specialist

Remote

**Experienced Customer Care Agent - Live Chat Support Specialist (Remote) - arenaflex**

Remote

Clinical Review Nurse - Prior Authorization - Remote CA

Remote

Experienced Medical Assistant – Virtual Healthcare Services Representative at careerzynith

Remote

PART TIME - and Health Insurance Benefit Advisor - Completely Remote

Remote

Experienced Data Entry Specialist – Remote Work Opportunity with careerzynith

Remote

Virtual Training (Remote) Personal Trainer

Remote

Virtual Math Educator (New York State Certified)

Remote

[Remote] Solution Architect-WWPS-Army, US Army

Remote
← Back