Integrated Resources
Coordinator I - Prior Authorization & Appeals
Integrated Resources, Providence, Rhode Island, us, 02912
Job Title: Coordinator I - Prior Authorization & Appeals
Location:
Remote 02895 (Work from Home) Duration:
6 Months+ (Possibility of Extension)
Pay Rate:
$16/hr. on W2
Position Summary: The Coordinator I, Prior Authorization & Appeals, performs non-clinical support tasks aligned with established policies, procedures, and regulatory requirements. Reporting to the Clinical Supervisor, this role ensures compliance with ERISA, CMS, Medicaid, and client-specific standards while supporting the team to meet business objectives and service level agreements. Exceptional customer service and accuracy are critical in this role.
Key Responsibilities: Sort and process incoming faxes and mail in compliance with departmental and client standards. Complete transactions accurately and promptly to meet or exceed client service level agreements. Review and ensure adherence to ERISA, CMS, Medicaid, and client-specific requirements. Collaborate with team members to achieve operational goals and maintain client satisfaction. Perform detailed data entry and maintain accurate documentation.
Required Experience:
6 months to 1 year of data entry experience. Proficient in Microsoft Word and Excel. Strong problem-solving, analytical, written communication, and interpersonal skills. Ability to type 25-30 words per minute. Highly detail-oriented with excellent organizational abilities.
Preferred Experience:
1 year of healthcare industry experience (hospital, managed care, physician office, PBM, etc.). Familiarity with prescription drug products, dosage forms, and usage. Knowledge of medical and/or pharmacy terminology.
Education:
High school diploma or GED required.
Schedule:
Work hours: Monday - Friday, between 7:00 AM - 8:00 PM CT (shifts may vary). Training hours: 8:00 AM - 4:30 PM CT.
Remote 02895 (Work from Home) Duration:
6 Months+ (Possibility of Extension)
Pay Rate:
$16/hr. on W2
Position Summary: The Coordinator I, Prior Authorization & Appeals, performs non-clinical support tasks aligned with established policies, procedures, and regulatory requirements. Reporting to the Clinical Supervisor, this role ensures compliance with ERISA, CMS, Medicaid, and client-specific standards while supporting the team to meet business objectives and service level agreements. Exceptional customer service and accuracy are critical in this role.
Key Responsibilities: Sort and process incoming faxes and mail in compliance with departmental and client standards. Complete transactions accurately and promptly to meet or exceed client service level agreements. Review and ensure adherence to ERISA, CMS, Medicaid, and client-specific requirements. Collaborate with team members to achieve operational goals and maintain client satisfaction. Perform detailed data entry and maintain accurate documentation.
Required Experience:
6 months to 1 year of data entry experience. Proficient in Microsoft Word and Excel. Strong problem-solving, analytical, written communication, and interpersonal skills. Ability to type 25-30 words per minute. Highly detail-oriented with excellent organizational abilities.
Preferred Experience:
1 year of healthcare industry experience (hospital, managed care, physician office, PBM, etc.). Familiarity with prescription drug products, dosage forms, and usage. Knowledge of medical and/or pharmacy terminology.
Education:
High school diploma or GED required.
Schedule:
Work hours: Monday - Friday, between 7:00 AM - 8:00 PM CT (shifts may vary). Training hours: 8:00 AM - 4:30 PM CT.