Strategic Staffing Solutions is currently looking for Prior Authorization Specialists for a contract opportunity with one of our largest clients located in Detroit, MI!
Location: Detroit, MI (2 weeks onsite training then 100% remote)
Duration: 12+ Months
Role Type: W2 contract engagement
ROLE SUMMARY
Medicare Advantage Post-Acute Care Specialist:
Support healthcare providers and UM reviewers with prior authorization requests for post-acute care services.
Includes manually entering authorization requests into healthcare system, 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.
Requirements:
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 of post-acute care functions and processes or discharge readiness activities may be preferred for some positions.