Authorization Assistant -Temporary

Authorization Assistant I-Temporary page is loaded## Authorization Assistant I-Temporary locations:
Portland Oregon:
Remote Washington time type:
Full time posted on:
Posted Yesterday job requisition :
JR100579

Authorization Assistant I-Temporary---------------------------------------------------------------The Temporary Authorization Assistant I provides technical and clerical support related to one (1) assigned focus area (functional area or line of business). Focus areas include physical health, behavioral health, health-related services, durable medical equipment, Medicare, Medicaid and/or other areas. The position receives requests for support from members, providers, vendors, and brokers as well as internal customers. In all communications and job duties, the role is responsible for adhering to departmental processes, federal and state rules and regulations, and contractual regulatory requirements.  

This is a temporary position lasting up to 6 months with potential to extend.
** Estimated Hiring Range:**$22.82 - $27.89
** Bonus Target:
** Bonus - SIP Target, 5% Annual Current Care Oregon Employees:
Please use the internal Workday site to submit an application for this job.

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** Essential Responsibilities
*** Responsible for supporting (1) focus areas.
* Assist with complex work to the extent capable.
* Verify member eligibility and determine the primary insurer.
* Verify network providers.
* Verify non-network providers are loaded into QNXT.
* Verify codes and benefits, including benefit limits, based on the applicable line of business (e.g., Medicare, Medicaid, etc.).
* Communicate with members, providers, and all business associates in accordance with state and federal requirements as needed to complete requests.
* Communicate via the phone (placing and receiving phone calls) as necessary.
* Obtain additional information as needed from the requestor or other providers in accordance with department processes.
* Process requests based on the members primary or secondary insurance as appropriate in accordance with department policies, procedures, and timelines.
* Respond to inquiries in a timely manner.
* Responsible for consistently meeting production and quality standards.
* Document information received and action taken according to the department’s documentation standards.
* Upon the completion of requests, organize and review documents to ensure all required information is accurate and complete in the system and in accordance with established protocols.
* Ensure naming conventions are consistent across all platforms and in accordance with department documentation requirements.
* Create appropriate member/provider notification based on request outcome.
* Act as a resource to both internal and external customers regarding authorization requests.
* Maintain confidentiality and adhere to HIPAA requirements.
* Contribute to the Clinical Operations department effort to reach goals.
* Participate in cross-departmental work groups as needed.
* Learn how to fix report errors.
* Serve as a tester for system updates and/or implementations as needed.
* Contribute suggestions to improve processing guides.
* Participate in job shadowing as needed.
* Cross-train and attend to duties outside of focus area as needed:
* Process retroactive authorization requests for approvals and determine if claim was denied, and if so, notify claims department to reprocess appropriate claim(s)
* Notify providers of admission and discharge dates
* Research and resolve questions related to hospitalizations or other facility admissions and discharges
* Work with clinical staff to ensure length of stay follows required procedures and meets federal compliance standards
* Review census reports daily to ensure timely review is conducted###
** Experience and/or Education
** Required* Minimum 1 year experience providing technical, clerical, or administrative support (includes customer service roles that provide technical, clerical, or administrative support)
Preferred
* Experience working with electronic medical records
* Experience processing Medicare, Medicaid, or commercial plan authorization requests
* Experience working with coding and medical terminology### Knowledge,

Skills and Abilities

Required Knowledge
* Awareness of the Oregon Health Plan (OHP) and Medicare A & B benefit packages
* Basic knowledge of medical terminology, ICD
10, and CPT coding helpful

Skills and Abilities

* Ability to consistently meet production standards
* Ability to consistently meet high quality standards
* Ability to and willingness to cross-train as needed
* Strong computer application skills in MS Office including Word, and Outlook
* Ability to learn business applications
* Fast and accurate data entry
* Ability to attend to detail and accuracy
* Good organizational skills
* Growing ability to effectively manage multiple tasks, prioritize and process a high volume of work
* Communicate effectively, both verbally and in writing
* Good customer service…