Prior Authorization Specialist

STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING Strategic Staffing Solutions is currently looking for Prior Authorization Specialists for a contract opportunity with one of our largest clients located in Detroit, MI Title: Prior Authorization Specialists – multiple openings Location:

Detroit, MI Duration: 12 Months Role Type: W2 contract engagement ROLE SUMMARY Medicare Advantage Post-Acute Care Specialist: • Support healthcare providers and UM reviewers with prior authorization requests for post-acute care services. • Includes manually entering authorization requests into healthcare system, following rules and algorithms embedded in the care management system to administratively approve prior authorization requests. • May work with providers to secure discharge plans, Notice of Non-Medical Coverage, Durable medical equipment, and other home supports required for discharge planning. • May support scheduling physician to physician calls. • Will support appeal processes for CMS designated Quality Improvement Organization appeals including logging all appeal activities. Requirements: • High School Graduate or GED equivalent required. • Two (2) years of college preferred. • Two (2) years’ experience as medical assistant, care technician, post-acute care and home health care support staff or ancillary services in other health care related field preferred. • Knowledge of post-acute care functions and processes or discharge readiness activities may be preferred for some positions.