Prior Authorization Coordinator

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company’s growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.
For more than 25 years, NTT DATA Services have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.
NTT DATA Services currently seeks a Prior Authorization Coordinatorto join our team working remote.
The Prior Authorization (PA) Coordinator works with the PA nurses and provider offices to help ensure review of coverage authorization requests for members. The responsibilities of this position include data entry, inbound and outbound telephone contact with providers, maintaining security of Protected Health Information (PHI), and processing authorization approvals that do not require clinical review. You will provide opportunities to contribute to multiple projects and cross-training for Concurrent Review authorization processing contingent upon departmental needs.
Responsibilities:

• Manage incoming coverage authorization requests, entering them into the authorization software or re-directing them to appropriate entities outside of client.
• Process authorization requests using client procedures and electronic resources and refers cases to the Prior Authorization Nurse for medical necessity or benefit review within mandated regulatory timeframes.
• Work with provider, facility and vendor office and delegated group staff to promptly answer questions and resolve issues related to authorizations.
• Maintain accurate documentation of provider calls within authorization records.
• Maintain databases for reporting requirements.

Requirements:

• 1 year of experience with state and federal insurance programs from a provider or payer setting.
• Bachelor's degree in Social Sciences, Life Sciences, Business or a related field or equivalent work experience.
• Knowledge of medical terminology and familiarity with diagnosis and service codes (ICD/CPT/HCPCS).
• Experience with health information system applications and Microsoft Office products.

About NTT DATA Services:
NTT DATA Services is a recognized leader in IT and business services, including cloud, data and applications, headquartered in Texas. As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. We are committed to our clients' long-term success. Visit nttdata.com or LinkedIn to learn more.
NTT DATA Services is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is $19.25-20/hr. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.
This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.