Care Operations Associate
New
Based in United States, Central Time business hoursFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- At least 2 years of experience in healthcare administration or operations
- Required Skills
- CRMEHRHIPAA
Requirements
- At least 2 years of experience in healthcare administration or operations.
- Hands-on experience with prior authorization, insurance verification, or eligibility processes.
- Strong knowledge of payer portals, authorization workflows, appeals, and healthcare administrative procedures.
- Experience using CRM, EHR, document management, and fax systems.
- Proven ability to manage large volumes of detailed administrative work with high accuracy.
- Experience collaborating with provider offices, insurance payers, pharmacy partners, and staffing agencies.
- Ability to work independently in a fully remote environment.
- Must be available during Central Time business hours.
Responsibilities
- Verify member eligibility and insurance benefits, confirming coverage, authorization requirements, and cost-sharing details.
- Manage prior authorization requests, renewals, and extensions by preparing documentation and tracking approvals.
- Coordinate the collection of medical orders, referrals, clinical documentation, and provider signatures.
- Organize clinical staffing schedules and coordinate medication shipments with external partners.
- Provide professional inbound support for healthcare providers, pharmacy partners, and members.
- Develop, document, and improve operational workflows to support organizational growth.
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