PriorAuthRepresentativeAssociate

## **Job Summary** Provides clerical support to assist in the delivery of quality healthcare services via a Financial Clearance model by way of obtaining accurate and timely authorizations. Crucial to obtaining an authorization is the ability to read and understand basic insurance information as well as perform a complete and accurate registration. Training will consist of six weeks of in-person instruction and will shift to remote training after that time pursuant on satisfactory progress including authorizations obtained daily and a passing audit score. ## ## **Essential Functions** * Demonstrates the ability to utilize all payer websites and maintains up to date credentials to assist verifying patient’s coordination of benefits and authorization requirements. * Able to perform chart abstraction to pull clinical data from a patient’s chart for review by a payer’s clinical team., * Adheres to all department procedures, guidelines, and standard work with the ability to utilize resources appropriately. * Complete authorization requests in a timely and efficient manor without compromising quality to ensure patients receive their care as scheduled * Communicates barriers effectively to avoid patient delays in care demonstrating critical thinking skills to anticipate and resolve barriers to success. * Maintains a 90% or higher audit score consistently and be receptive to constructive feedback. * Proficient in one primary service area with a firm understanding of the industry standard authorization requirements. * Able to obtain 15 authorizations daily (consideration for type of service line) ## **Qualifications** Required * High School Diploma or equivalent * 1 year of relevant experience in related field Preferred * Basic understanding of medical terminology * Prior Authorization experience * Epic experience * Payor portal experience **About Corewell Health** As a team member at Corewell Health, you will play an essential role in delivering personalized health care to