Authorization Support Representative II

Important things YOU should know:

• Schedule: Monday - Friday - 8:00am -5:00pm CST
• Holiday/weekend coverage required on a rotational basis
• Fully Remote Role

What will YOU be doing for us? Responsible for administrative support for the authorizations team including initial review of authorizations to ensure completeness of submission.

What is in it for YOU?

• Career growth in an inclusive culture
• Paid training
• Health benefits
• 401 (k)

What will YOU be working on?

• Maintain accurate and detailed notes of work performed in the company system and in other appropriate documents/spreadsheets.
• Contact provider offices via phone and written communication to obtain missing clinical information needed in support of the pre-authorization determination process.
• Provide administrative support to team by performing various duties including but not limited to pulling information for audits, entering denial reasons and authorization schedules into internal systems, following up on non-clinical issues/requests.
• Modify authorizations as required/requested.
• Respond to questions from internal customers in a thorough and timely manner utilizing communication that is easily understood by others.
• Identify authorizations that require provider or member outreach in an effort to obtain additional information.

Additional Responsibilities:

• Utilize resources available to maintain current knowledge and understanding of dental plans and coverage provided.
• Print and mail all authorization decision letters to members.
• Send all appropriate authorization decision letters to providers via fax.
• Handle any exceptions (incorrect fax number, fax system issues, etc.) individually to ensure correct delivery
• Ensure all automated authorization notifications are sent by using appropriate internal dialer system.
• Ensure any additional supporting information sent is attached to the appropriate authorization prior to review.

What qualifications do YOU need to have to be a GOOD candidate?

• Required Level of Education, Licenses, and/or Certificates
  • High school diploma or equivalent

• Required Level of Experience
  • 1+ years of experience in an administrative role in a dental office or other similar related experience

• Required Knowledge, Skills, and Abilities
  • Excellent Computer literacy including strong proficiency in Microsoft Office
  • Excellent organizational skills to ensure required deadlines are met
  • Demonstrated problem solving skills to allow for the correct diagnosis of a problem along with potential solutions for resolution
  • Excellent communication skills

What qualifications do YOU need to have to be a GREAT candidate?

• Preferred Level of Education, Licenses, and/or Certificates
  • Postsecondary education in a related field

• Preferred Level of Experience
  • 3+ years of administrative/clerical/clinical experience in a dental office or similar related experience.

• Preferred Knowledge, Skills, and Abilities
  • Strong proficiency in Microsoft Office Suite
  • Ability to quickly learn and incorporate new software into daily duties
  • Excellent verbal and written skills
  • Knowledge of Enterprise and/or Electronic Medical Record system
  • Willingness to learn dental procedures, terminology and codes

Compensation Range:

Compensation Midpoint: