Prior Authorization Workflow Consultant
New
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Humata Health, IncHealthcare Technology
Remote, US or Hybrid - Orlando, Florida, USFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- 3+ years
- Required Skills
- Data AnalysisMicrosoft Power BIGoogle WorkspaceSlack
Requirements
- Bachelor’s degree in Business, Healthcare Administration, or a related field.
- 3+ years hands’ on Prior Authorization experience.
- Familiarity with healthcare operations, prior authorization, or revenue cycle workflow optimization.
- Systems knowledge/expertise with Epic (referrals, work queues, coverage).
- Experience with payer portals and revenue cycle operations.
- Hands-on data analysis experience.
- Ability to analyze referral volumes service line/payer.
- Ability to document processes (current state and future-state).
- Proficiency with PowerBI, Google Workspace, and Slack.
- Willingness to travel (up to 25%).
Responsibilities
- Own the operational workstream deliverables for customer implementations including discovery, data collection and analysis of Prior Authorization workflows.
- Proactively manage all operational workstream tasks of the implementation project plan.
- Conduct operational workflow and portal shadowing sessions with customers.
- Capture and document operational workflows in Humata’s design workbook.
- Review customer payer/plan mix and formulate automation workflow recommendations.
- Adapt future-state workflows and payer/portal additions for customers.
- Create payer portal credentials to support Humata’s automations.
- Own payer portal validation during testing and go-live project phases.
- Document and escalate validation issues to the Engineering team.
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