Client Services Analyst

A company is looking for a Client Services Analyst I (Fully Remote - USA).

Key Responsibilities

Process incoming prior authorization and referral requests, ensuring accuracy and compliance with regulations

Validate prior authorization requests against established policies and communicate discrepancies for investigation

Monitor processing activities to ensure adherence to legal requirements and update systems with patient information

Required Qualifications, Training, and Education

Experience in processing prior authorization and referral requests in a healthcare setting

Proficient in interpreting EOB and UB-04 claim forms, with knowledge of medical coding (CPT, HCPCS, ICD-10)

Familiarity with insurance payers and Medicaid policies

Strong analytical skills to ensure data accuracy and resolve issues

Proficient in Microsoft Excel, Visio, and PowerPoint