Prior Authorization Specialist bei Jericho Road Community Health Center

PRIOR AUTHORIZATION SPECIALIST

Jericho Road Community Health Center is actively seeking a Prior Authorization Specialist. This position is full-time, within the Services Support Department, working at the 184 Barton location

Work with a Purpose 

Jericho Road Community Health Center offers the opportunity to engage in a movement far larger than any one individual. We believe that we can all be people with positive influence. We influence each other, our clients and patients, our families and communities. We are part of a global team that influences the health and wellbeing of communities internationally. Every day, Jericho Road’s mission of caring for communities and advocating for systemic health equity guides us in our collective purpose. We are looking for individuals who share that goal and are committed to that service. As a federally qualified health center (FQHC), our organization’s mission is deeply rooted in making fundamental changes in the communities we serve, advocating for social justice and meeting people where they are. With global clinics across the world, the impact you make will transcend borders, with opportunities to engage in meaningful work at our Sierra Leone, Goma or Nepal global clinics.  

Why Jericho: Jericho Road offers competitive pay and benefits including medical (single-high coverage paid in full by employer), HSA, dental, vision, employer paid life insurance benefit, supplemental insurances, tuition discounts, generous paid time off, the opportunity for global travel to our three global health clinics, and loan forgiveness for applicable positions. Jericho Road values both work and life. The option of a flexible 40-hour workweek is possible within certain teams. 

Responsibilities: 

• Receive requests for pre- authorizations and ensure that they are properly and closely monitored and processed in a timely manner because of patient care
• Review accuracy and completeness of information requested and ensure that all supporting documents are present 
• Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed
• Look through denials and submit appeals in a bid to get them approved from insurance companies in a timely manner
• Help develop and implement prior authorization workflow, policies, and procedures
• Secure patient’s demographics and medical information by using great discretion and ensuring that all procedures are within HIPAA compliance and regulation
• Communicate with patients in receiving authorizations for their medications, imaging physical therapy and procedures
• Manage correspondence with insurance companies, physicians, specialists, and patients 
• Communicate with providers regarding the peer to peer (P2P) process accordingly
• Ensure all actions, personal conduct, and communications across all entities (coworkers, patients, and representatives from other organizations) always represent the organization in a highly professional manner

Qualifications:                   

• High School graduate or GED equivalent
• Reliable transportation 
• Working knowledge of medical business office procedures and detailed understanding of ICD-10(diagnosis) and CPT codes. 
• Working knowledge of medical terminology

Rate: $17.50 an hour. Individual compensation is based on various factors unique to each candidate, including skill set, experience, qualifications, and other position related components. 

Job postings are not intended to be an exhaustive list of duties. You will be expected to perform different tasks as necessitated or required by your role within the organization and the overall missional objectives of the organization.  

Jericho Road is an Equal Opportunity Employer. We are an inclusive organization and actively promote equity of opportunity for all.