Dean’s Professional Services is now hiring a qualified, patient-care-focused Authorization Specialist IIto work in a Hospital Facility inthe Texas area. – Remote

We are on a mission to create care that’s more convenient and professional. With solutions that are value-based and patient-centered. To accomplish this, we are looking for individuals who share our sense of excellence and are ready to embrace new opportunities!

The Authorization Specialist II is responsible for acting as a resource and supports the prior authorization request process to ensure that all authorization requests are addressed properly in the contractual timeline. Supports utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibility and access.

Job Responsibilities:

• Seeking candidates ideally with call-center and medical insurance experience. Position is for call-center employee (referral specialist) in prior authorization department.
• Initiate authorization requests for outpatient and inpatient services in accordance with the prior authorization list
• Route to appropriate staff when needed.
• Verify eligibility and benefits.
• Answer phone queues and process faxes within established standards Data enters authorizations into the system.
• Knowledge of medical terminology and insurance preferred. 
• Aids the utilization management team and maintains ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines.
• Supports the authorization review process by researching and documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination
• Verifies member insurance coverage and/or service/benefit eligibility via system tools and aligns authorization with the guidelines to ensure a timely adjudication for payment
• Performs data entry to maintain and update various authorization requests into utilization management system
• Supports and processes authorization requests for services in accordance with the insurance prior authorization list and routes to the appropriate clinical reviewer
• Remains up-to-date on healthcare, authorization processes, policies and procedures
• Performs other duties as assigned
• Complies with all policies and standards

Job Requirements:

• High school diploma or equivalent – Required
• Minimum 2 years of Customer Service experience. - Required
• Previous WFH experience – Required 
• 6 months of Call center experience – Highly Preferred 
• Healthcare or Medical Office preferred (but not required), 
• Experience taking inbound and outbound calls in a call center or call center environment (this will be an inbound call-taking position)
• MS Outlook, MS Excel, Zoom, TEAMS Knowledge – Required 
• Minimum of 35-45 wpm typing 
• Basic Internet skills, multi-line phone experience
• Must be technologically savvy and computer literate. 
• Ability to navigate multiple programs simultaneously

Job Details:

• Schedule: Monday– Friday 8am – 6pm
• Starting at $17/hr. (Based on experience) 
• Full benefits – healthcare, dental, vision, 401k program.
• Temp-to-Hire opportunity.

Dean’s Professional Services is a national, award-winning staffing solutions firm. Since 1993, DPS has placed over 45,000 professionals across the nation. We work with our clients to provide placement opportunities that match your skill, experience, and personality. For more information, please visitwww.deansprofessionalservices.com.