Healthcare Prior Authorizations Specialist - REMOTE

Healthcare Prior Authorization Specialist - REMOTE

Join to apply for the Healthcare Prior Authorization Specialist - REMOTE role at Quadris Team, LLC
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4 days ago Be among the first 25 applicants.

Quadris Team, LLC – a Revenue Cycle Management Group – seeks a dynamic person to join our highly skilled Authorizations Team as Prior Authorization Specialist for General Surgery. We are a 100% remote team supporting clients across the United States.

The ideal applicant will reside in Pacific Standard Time or Mountain Standard Time.

• Obtain prior authorizations for facility services based on assigned specialty or clinic area.
• Secure the prior authorization and notify the rendering party in a timely manner so patients can receive necessary care with minimal delay.
• Answer patient calls and provide outgoing communication regarding financial obligations, authorization status, patient estimation, benefit education, and payment processing.

• Accurately, efficiently, and timely work on prior authorization requests/referrals.
• Receive requests through the EHR, phone, email, or fax and ensure proper tracking.
• Process referrals and submit medical records to insurance carriers to expedite approvals.
• Manage correspondence with insurance companies, physicians, specialists, and patients; document in the EHR as appropriate.
• Assist with medical necessity documentation and follow-up to expedite approvals and submit appeals of denials.
• Review accuracy and completeness of information and ensure all supporting documents are present.
• Prioritize incoming authorizations by urgency and date of service.
• Secure patient information in accordance with client policy and procedures.
• Other duties as assigned, monitor WQs, and resolve accounts promptly.
• Stay up to date on insurance company policies and procedures related to prior authorizations.

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift 15 pounds at one time.
• Must structure your home office to secure patient information and meet regulatory expectations.

• Maintain compliance with applicable regulations and laws.
• Professional level communication via video, phone, and email.
• Effectively prioritize work to meet deadlines and expectations.
• Meet the quality and productivity measures set by Quadris.
• Bring positive energy to work, use critical thinking, and stay focused on assigned tasks.
• Be a self‑starter, work independently and within a team atmosphere.

• High School diploma or equivalent.
• 1+ years of experience in health care, medical billing, with a focus on prior authorization preferred.
• PACS (Prior Authorization Certified Specialist) certification preferred.
• Knowledge of insurance processes and medical terminology preferred.
• Honors patient confidentiality and customer service; adherence to Quadris policies and HIPAA requirements.
• Advanced level of industry‑standard electronic medical record content.
• Professional level skills in MS products such as Excel, Word, PowerPoint.
• Proficient application of business/office standard processes and technical applications.

Salary: $19.00 - $22.00 per hour

• Entry level

• Full-time

• Health Care Provider

• Hospitals and Health Care