Prior Authorization Specialist I

Myndshft Technologies, Inc. Mesa , AZ 85201

Posted 1 week ago

This is not your typical insurance prior authorization job. As our PA Specialist, you will leverage your verification and authorization expertise to update and maintain our prior authorization/ medical guideline rules library with the most up to date coverage information. You will have the opportunity to grow your career by joining a team at the ground level, shaping our approach to obtaining prior authorization requirements from insurance companies. In this role you will:

  • Find, read, understand, and parse prior authorization rules and regulations for insurance companies
  • Use an internal tool to populate unformatted insurance and authorization requirements into a common format
  • Keep documentation updated when changes are made to prior authorization requirements by insurance companies
  • Interface with software development teams to suggest and QA functionality added to rules engine products and UI for data population
  • Interface with customers to parse contractual rules and update them into a standard format in the Myndshft rules engine
  • Other duties as assigned

Requirements

  • Experience submitting prior authorization through multiple commercial payers, and navigating insurance verification. You know exactly where to find this information, and how to interpret the requirements. You've likely been doing this for at least 2 years.
  • Solid understanding of commercial insurance payer processes and insurance verifications
  • Comprehensive understanding of related medical terminology
  • Excellent research & comprehension skills when navigating authorization jargon.
  • High level of comfort navigating unfamiliar technologies.
  • Ability to work collaboratively and independently.
  • Experience working with ICD-10, CPT, and HCPC codes.

Helpful but not required experience

  • Experience navigating the payer review process.
  • Expert knowledge of challenges of submitting prior authorizations via fax, payer portals, and/or phone.

Benefits

  • Competitive salary that correlates with your ability to contribute
  • Generous vacation+ sick time allotment
  • 4 hours/ month paid community service time
  • Equity incentive plan
  • Medical, Dental, & Vision, GTL, STD, LTD Insurance with employer contribution
  • 401k + Employer Match
  • Fun office perks including snack bar, dog-friendly environment, recreation room, modern layout, and indoor/ outdoor transitional space
  • Continued learning in form of brown bag lunches, training sessions and intra-company events.

ABOUT MYNDSHFT

Myndshfts software-as-a-service automates and simplifies time-consuming healthcare administrative tasks associated with prior authorization, eligibility and benefits verification, and patient financial responsibility, freeing providers and payers to concentrate more fully on patient care again. Myndshft was founded in 2015, and works with leading providers, payers, and health information exchanges.

COMMITMENT TO DIVERSITY & INCLUSION

We value diversity and inclusion, and strive to build teams which include people from a variety of backgrounds, perspectives, and skills. Diversity makes us tick, and we are better together. That said, we are an equal opportunity employer. You will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Disclaimer

This job description is subject to change at any time. We are a startup, and we all wear many hats. As part of your employment, you may be asked to perform duties outside of this job description. Please see your immediate supervisor with any questions you may have.

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Prior Authorization Specialist I

Myndshft Technologies, Inc.