Job Description

• Training will be onsite in Detroit, MI - Thereafter it's a remote role
• Support Client's providers and UM reviewers with prior authorization requests for post-acute care services.
• Includes manually entering authorization requests into client's Care Management systems, 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 Client designated Quality Improvement Organization appeals including logging all appeal activities.

• High School Graduate or GED equivalent required.
• Two years of college preferred.
• Two 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 post-acute care functions and processes or discharge readiness activities may be preferred for some positions.

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