RedValley, the coolest and fastest-growing company, is seeking an experienced _ Prior authorization specialist _ to join our new medical team You will be responsible for obtaining pre-certifications and pre-authorizations for procedures and medications, scheduling appointments for outpatient testing with other providers, transcribing and triaging patient calls to physicians, and coordinating patient appointments/orders. What You'll Do Review chart documentation to ensure the patient meets medical policy guidelines Prioritize incoming authorization requests according to the urgency Obtain authorization via the payer website or by phone and follow up regularly on pending cases Maintain individual payer files to include up-to-date requirements needed to successfully obtain authorizations Initiate appeals for denied authorizations Respond to clinic questions regarding payer medical policy guidelines Confirm the accuracy of CPT and ICD-10 diagnoses in the procedure order Contact patients to discuss authorization status Other duties as assigned, aligned with the job responsibilities What You'll Bring To The Team Strong spoken and written English B2+1+ Years of Experience in prior authorizations 3+ Years of Experience in the healthcare industry Experience with procedure authorizations in any medical field Basic typing and keyboarding skills Strong oral and written communication skills Highly detail-oriented Basic understanding of human anatomy, specifically musculoskeletal Proficient use of CPT and ICD-10 codes We Offer You Opportunities to work in a fast-paced startup environment supportive of teamwork, ownership, and purpose. Flexible working environment (flexible working hours, working from our state-of-the-art office space in El Poblado). One-of-a-kind company values and teamwork culture as well as a meaningful mission and challenging work. Private health insurance for you plus a family member. Great discount on lunch with our partnered restaurants Job Type: Full-time Application Question(s): Could you please rate your English proficiency on a scale of 1 to 10? Experience: Prior Authorization: 1 year (Preferred) Healthcare: 2 years (Preferred)#J-18808-Ljbffr