Job Information
G-TECH Services, Inc. Prior Authorization Specialist in Detroit, Michigan
Support providers and reviewers with prior authorization requests for post-acute care services. Includes manually entering authorization requests into Care Management systems, following rules and algorithms embedded in the care management system to administratively approve prior authorization requests. May work with providers to secure discharge plans, Notice of Non-Medical Coverage, Durable medical equipment, and other home supports required for discharge planning. May support scheduling physician to physician calls. Will support appeal processes for CMS designated Quality Improvement Organization appeals including logging all appeal activities. High School Graduate or GED equivalent required. Two (2) years of college preferred. Two (2) years experience as medical assistant, care technician, post-acute care and home health care support staff or ancillary services in other health care related field preferred. Knowledge post-acute care functions and processes or discharge readiness activities may be preferred for some positions.
Category Sales
Function Clerical / Administrative
Req ID JN -062024-121295