Remote Optum Prior Authorization Jobs in Oregon (NOW HIRING)

Location: RemoteSchedule: Monday-Friday, 8:00 AM-5:00 PM (Candidate's Local Time)Pay: $20.00-$22.00/hour based on experience

BlueSprig is seeking a detail-oriented and customer-focused Insurance Authorization Specialist to join our Operations Support team. In this role, you will play a vital part in ensuring our clients receive timely access to medically necessary services by managing insurance authorization requests and supporting our clinical teams.

The ideal candidate has experience working with insurance payers, thrives in a fast-paced environment, and is comfortable balancing independent work with cross-functional collaboration. This position reports directly to the Authorization Supervisor.

• Submit initial and ongoing insurance authorization requests accurately and efficiently.
• Monitor authorization status and follow up with insurance payers as needed.
• Communicate with insurance companies, clinic teams, and internal departments regarding authorization updates.
• Maintain accurate documentation within company systems.
• Ensure authorizations are obtained in a timely manner to support continuity of care.
• Provide exceptional customer service while resolving authorization-related questions and issues.
• Prioritize multiple tasks and meet established deadlines in a fast-paced environment.
• Collaborate with internal teams to improve processes and ensure operational excellence.

Required Qualifications:

• Experience working with insurance payers.
• Prior insurance authorization experience.
• Strong computer proficiency and the ability to learn new systems quickly.
• Excellent organizational, time management, and communication skills.
• Ability to work independently while collaborating effectively with a remote team.
• High attention to detail and accuracy.

Preferred Qualifications:

• Previous experience in Applied Behavior Analysis (ABA) or a healthcare setting.
• Experience supporting pediatric healthcare or behavioral health services.

At BlueSprig, our mission is to change the lives of children with autism through compassionate, evidence-based care. Behind every successful authorization is a team member helping families access the services they need. If you're passionate about making a meaningful impact while working with a supportive and collaborative team, we'd love to hear from you.

• Submit authorizations by contacting payors in a timely manner via phone as well as various portals
• Understand the authorization process and navigate the payor requirements accordingly
• Enter authorization information accurately in Central Reach system
• Provide clear, concise communication regarding authorizations to center team members
• Provide support to clinics in review of authorization requests
• Collaborate with all RCM teams and other departments to ensure efficiencies and strong communication and escalation of issues and/or enhancements
• Identify critical issues and provide possible solutions in addition to elevating problems to leadership
• Collaborate with the Auth/VOBE Supervisor on special projects, work flow optimization and improvement efforts
• Prioritize and multi-task efficiently while balancing a large work volume

• Exceptional analytical, conceptual, and problem solving skills with the ability to define problems, and disseminate significant amounts of information with attention to detail and accuracy
• Self-starter who can work in an unstructured environment, independently or in collaboration with a team
• Inherent flexibility in demeanor with a positive can-do attitude and an entrepreneurial spirit
• Ability to prioritize and multi-task efficiently while balancing a large work volume
• Demonstrated ability to effectively communicate both verbally and written
• Possess strong organizational and follow up skills with an ability to work well under pressure
• Ability to develop effective working relationships within the RCM department and across the organization
• 1+ years of experience in healthcare authorizations preferred
• Strong knowledge of Microsoft Excel and Word
• Monitor authorization expirations and timely submission authorization requests

As a result of President Biden Executive Order and in anticipation of the Occupational Safety and Health Administration (OSHA) directive all candidates must be aware that BlueSprig will be required to comply with both the order and OSHA directives, as necessary. Therefore, all BlueSprig employees may be required to be vaccinated or provide evidence of a required work accommodation.

Washington Candidates:

Per the directive of Washington Governor Jay Inslee, all health care providers in the private health care sector must be fully vaccinated by 10/18/21. This includes most employees, contractors, volunteers, and other positions that have any onsite presence. Therefore, all BlueSprig employees must be vaccinated or provide evidence of a required work accommodation.

Oregon Candidates:

Per the directive of Oregon Governor Kate Brown, all health care providers who have direct or indirect contact with clients must be fully vaccinated by 10/18/21.

At BlueSprig, we are dedicated to ensuring a level playing field for all. As part of that, we work hard to maintain our Great Place To Work status so that everyone is rewarded fairly and earns opportunities for bringing their whole and best selves every day, to allow for the fulfillment of our mission to change the world for children with autism.  

Sometimes the confidence gap and imposter syndrome can make someone doubt themselves and reconsider applying for a job that they love. Well, we're called BlueSprig for a reason - because we want to help everyone grow. If you want to be a part of our BlueSprig family, please apply as we would love to hear from you.