Government Tactical Solutions Hiring for Healthcare Authorization Specialist at Remote Full Time

This position can be 100% REMOTE or ONSITE
**ALL ONSITE CANDIDATES MUST BE FULLY VACCINATED FOR COVID**

**Remote candidates DO NOT need to be vaccinated for COVID as
they will not go onsite**

Shift: 40 hours per week, Mon-Fri between 7am-7pm PST
***Flexible work week available as long as schedule is consistent***

Interviews: All interviews will be virtual

Equipment: Computer, Internet and Headphones to be provided by Worker.

Training:
Will be provided by Rady Children’s through Zoom.

**Questionnaire below must be completed and included with
submission**

JOB SUMMARY:
Under general supervision this candidate will be responsible for ensuring that insurance benefits are verified, patient responsibility estimates are calculated and communicated to the patient and/or family, and authorization is secured timely for all assigned service types. The candidate will be responsible for being a specialist in their area for internal and external customer inquiries, as well as supporting various communication needs as required. Performs other duties as assigned.

REQUIREMENTS:
– 2 years of Healthcare, Medical Authorization Experience or 4 years of
Experience in Healthcare Revenue Cycle
– H.S. Diploma or GED
– Experience with EPIC or other EMR Systems (PREFERRED)
– Bilingual English/Spanish (PREFERRED)

Job Type: Full-time

Pay: $15.37 – $25.65 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

Application Question(s):

• Please describe the difference between PPO and HMO.
• Please describe the difference between referrals and authorizations

a. How many years of experience have you had with this?

• What is a Peer to Peer? What are the steps in handling a Peer to Peer?
• What is your understanding of Professional and Facility Fees?
• What is the filing order of insurances for the following scenarios:

a. Patient has Tricare and Medi-Cal coverage
b. Patient has Medi-Cal, a commercial plan, and Tricare

• A minor dependent has coverage through both parents. What information would be needed to determine what coverage would be primary?

Work Location: Remote