Pre-Authorization Coordinator

Overview

Who we are:

MotivHealth is a growing insurance company changing healthcare by focusing on HSA-based insurance plans that produce lower premiums, better benefits and the ability for employees to build significant health savings. MotivHealth drives a unique approach to healthcare solutions by enabling their members to price their healthcare, understand their provider quality, and control their overall healthcare experience. Motivhealth drives change at the member and provider level by always placing the member first. As a company MotivHealth is committed to changing healthcare, providing unmatched member experience, and lowering healthcare premiums.

Job Description

The Correspondence, Intake, and Appeals team is currently seeking a Pre-authorization Coordinator to join our team. This pivotal role is responsible for verifying insurance eligibility, benefits, and network status, ensuring accurate submission of ICD-10 and CPT codes. The coordinator is a vital link between payers and clinic schedulers following up on authorization requests, managing comprehensive documentation, and overseeing the authorization process from start to finish. With a keen eye for detail, you will help and support quality improvement initiatives by entering accurate information into our systems, scrutinizing structured clinical data, collaborating with clinicians on coverage inquiries, resolving treatment delays, and upholding strict member confidentiality standards.

Responsibilities

• Review and Prepare Pre-authorization letters for accuracy, save them in Docuware, and fax to the requesting provider.
• Provide exemplary customer service by answering calls/voice messages from physician offices, hospitals, and members.
• Accurately enter required information into the pre-auth app.
• Review structured clinical data and ensure compliance with specified medical terms and codes for final authorization or referral to Clinical Services.
• Interface with Clinicians to address coverage inquiries and facilitate treatment resolution, while maintaining member confidentiality.

Qualifications

• Required 2 years of healthcare financial experience or equivalent and previous experience with medical insurance and prior authorizations.
• Familiarity with human anatomy, medical terminology, and ICD-10/CPT coding.
• Strong critical thinking and problem-solving abilities.
• Excellent professional verbal and written communication skills.
• Proficiency in Microsoft Word and spreadsheets.
• Capacity to work independently and within a team, adapting to dynamic environments.
• Demonstrated ability to prioritize tasks, manage heavy workloads, and multitask effectively.

What We Offer

• 401(k) retirement savings plan with company match
• Wellness benefits including Medical, Pharmacy, Dental, Vision, Life, and Disability 
• Health Savings Account (HSA)
• Paid time off
• Professional development and Training
• Flexible work schedules - including work-from-home options available depending on role

Job Type: Full-time

Pay: From $19.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Ability to Relocate:

• South Jordan, UT 84095: Relocate before starting work (Required)

Work Location: In person