Top 455 Authorization representative Jobs in Tempe, Az

Prior Authorization Representative I
Arizona Priority Care —Chandler, AZ
- $20 - $23 an hour
- Full-time
- Hybrid work
- Office
- Administrative experience
- High school diploma or GED
Physician Assistant
CCRM Fertility —Scottsdale, AZ
- Full-time
- BLS Certification
- Clinic experience
- Mid-level
- Employee assistance program
- 401(k) matching
Quick Apply
Safety Manager
Haydon Companies —Phoenix, AZ
- Full-time
- Construction site
- Mid-level
- Bachelor's degree
- Disability insurance
- Health insurance
Quick Apply
MedTech - Clinical Educator Spine/OR - Multiple Locations
IQVIA —Phoenix, AZ
- $45 - $60 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Driver's License
Structures Aviation Maintenance Technician 145
Air Methods —Mesa, AZ
- Overtime
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Employee assistance program
Avionics Aviation Maintenance Technician 145
Air Methods —Mesa, AZ
- Overtime
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Employee assistance program
Route Performance Manager - Valley Metro
Keolis Transit America —Tempe, AZ
- $79,500 a year
- 8 hour shift
- CDL B
- Background check
- Clean driving record
- Health insurance
- Dental insurance
Quick Apply
8d
Project Accountant
Haydon Companies —Phoenix, AZ
- Full-time
- Research
- Mid-level
- Office
- Disability insurance
- Health insurance
Quick Apply
Mortgage Loan Officer
New American Funding. —Scottsdale, AZ
- $75,000 - $300,000 a year
- Full-time
- Mid-level
- Office
- High school diploma or GED
- Health savings account
- Paid holidays
Quick Apply
3d
Equipment Maintenance Technician - 12 HR Nights
Amcor —Tolleson, AZ
- $28 - $38 an hour
- 12 hour shift
- Mid-level
- 3 years
- Trade school
- Paid parental leave
- Health savings account
Quick Apply
Medical Receptionist-Bilingual Spanish
Center for Vein Restoration —Mesa, AZ
- $18 - $20 an hour
- Full-time
- Spanish
- HIPAA
- Administrative experience
- Paid holidays
- Health insurance
Quick Apply
Aviation Maintenance Technician 145
Air Methods —Mesa, AZ
- Overtime
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Employee assistance program
Caregiver - PT
MBK Senior Living —Gilbert, AZ
- Part-time
- Serving
- 18 years or older
- Current TB test
- Health insurance
- Dental insurance
Quick Apply
Orthopedic Technician
Select Ortho —Phoenix, AZ
- Full-time
- Anatomy knowledge
- Word processing
- Mid-level
Quick Apply
Inside Sales and Customer Service Representative
Rigid Industries —Gilbert, AZ
- $19.50 - $23.00 an hour
- Full-time
- Customer service
- Office
- High school diploma or GED
- Health insurance
- Dental insurance
Quick Apply
1d
Patient Care Rep - Intake Specialist/Coordinator
MedOne Healthcare —Chandler, AZ
- From $22 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Writing skills
- Health insurance
- Dental insurance
Quick Apply
2d
Maintenance Tech (Full-Time)
Home2 Suites Phoenix Downtown —Phoenix, AZ
- $18 an hour
- Full-time
- Ability to walk for extended periods
- Mid-level
- Hotel
- Wellness program
- Commuter assistance
Quick Apply
Patient Care Coordinator
CCRM Fertility —Scottsdale, AZ
- $21 - $24 an hour
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
- Commuter assistance
- Health savings account
Quick Apply
Claims Representative - Glendale, AZ
Federated Mutual Insurance Company —Glendale, AZ
- $63,800 - $78,000 a year
- Full-time
- Office
- Analysis skills
- US work authorization
- Health insurance
- 401(k)
Parts Counter Associate- Larry H. Miller Ford Mesa
Asbury —Mesa, AZ
- Full-time
- Bilingual
- 18 years or older
- Microsoft Outlook
- Paid training
- Paid parental leave
Quick Apply
4d

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Prior Authorization Representative I

Arizona Priority Care -
Chandler, AZ

Apply Now

Job Details

Full-time
$20 - $23 an hour

Qualifications

Administrative experience
High school diploma or GED
ICD-10
HCPCS
Desktop applications
Medical terminology

Full Job Description

Arizona Priority Care (AZPC) is an Integrated Provider Network focused on providing whole-person care to Senior and Medicaid populations, through advanced value-based models. Our provider network is comprised of more than 6,000 health care providers, including primary and specialty care physicians, hospitals and ancillary providers. We have operated in the Arizona market for more than 14 years, based in Chandler, Arizona, and are an affiliate of Heritage Provider Network. As a leading value-based provider organization, we are committed to improving the quality of care, providing excellent member and provider experiences all while reducing cost.

The Prior Authorization Representative I is responsible for processing incoming requests including verifying eligibility and benefits and the data entry component of the prior authorization request. The PA Rep I works closely with all UM Staff, Prior Auth Supervisor, and management to maintain turnaround time requirements of the contracted health plan, regulatory bodies, and internal goals. Routinely interacts with physicians, their office staff and internal customers.

POSITION DUTIES & RESPONSIBILITIES

Assist in managing the incoming prior authorization request by following work direction given by the Prior Authorization management to ensure Routine/Standard and Urgent/Expedited prior authorizations are processed in the appropriate amount of time and in compliance with regulatory and health plan requirements.
Complete a minimum data entry or adjudication of 40 authorizations per day.
Assist in reviewing and distributing incoming prior authorization requests including identifying Urgent/Expedited vs Routine/Standard, verifying member eligibility, delegated vs non-delegated services, retro vs. future date of services, accuracy checking documentation, and routing to appropriate folder.
Perform data entry of prior authorization requests with a minimum of 97% accuracy including primary insurance or hospice verification, determine if requested services require prior authorization, and confirm request is not duplicative.
Perform adjudication of authorization requests with a minimum of 97% accuracy including quality checking data entry, reviewing historical utilization management history to include program enrollment and verifying if rendering provider and facility is contracted, any tasks related to processing a prior authorization request (provider loads, out of network (OON) credentialing, accreditation verification, etc.), providing redirect information for OON requests, and routing to the appropriate queue or vendor.
Contact the provider’s office for additional information per CMS and AZPC policies and guidelines.
Make expedited determination notifications to member and provider.
Provide exceptional, courteous, and professional phone customer service.
Educate practitioners as needed with the Authorization/Referral process.
Perform as necessary accommodate to departmental change, workload and emergencies.
Maintain current knowledge of CMS and NCQA standards, and AZPC UM Policies and procedures.
Protect privacy for patients, providers, and employees; ensure all personal health information is kept confidential.
Demonstrate caring, empathy, patience, respect and compassion for all team members.
Demonstrate honesty and integrity in everyday activities.
Perform other duties as directed by management.

EDUCATION, TRAINING AND EXPERIENCE

Highschool Diploma or GED – Required.
Minimum of 1-year administrative healthcare related experience – Required.
Proficient knowledge of medical terminology, CPT-4, HCPCS, and ICD-10 – Required.
Working knowledge of computer applications, such as Microsoft Office applications.
Excellent oral and written communication skills.
Demonstrated ability to be detail-oriented and multi-task effectively.
Able to interact effectively with all levels of staff.

Pay Range: $20.00 – $23.00/hour

*This role requires 60 days FT in office presence, hybrid options will be available after the 60-day period.*

Apply Now

Refine Your Search

authorization representative jobs in tempe, az

Prior Authorization Representative I

Physician Assistant

Safety Manager

MedTech - Clinical Educator Spine/OR - Multiple Locations

Structures Aviation Maintenance Technician 145

Avionics Aviation Maintenance Technician 145

Route Performance Manager - Valley Metro

Project Accountant

Mortgage Loan Officer

Equipment Maintenance Technician - 12 HR Nights

Medical Receptionist-Bilingual Spanish

Aviation Maintenance Technician 145

Caregiver - PT

Orthopedic Technician

Inside Sales and Customer Service Representative

Patient Care Rep - Intake Specialist/Coordinator

Maintenance Tech (Full-Time)

Patient Care Coordinator

Claims Representative - Glendale, AZ

Parts Counter Associate- Larry H. Miller Ford Mesa

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