BusinessOperations - Authorization Specialist I - J00903

Position Purpose:
Supports the prior authorization request to ensure all authorization requests are addressed properly and in the contractual timeline. Aids utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibility and access.

Education/Experience:
Requires a High School diploma or GED.
Entry-level position typically requiring little or no previous experience.
Understanding of medical terminology and insurance preferred.


Supports authorization requests for services in accordance with the insurance prior authorization list

Supports and performs data entry to maintain and update authorization requests into utilization management system

Assists utilization management team with ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines

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