Prior Authorization Configuration SME

Job Summary

A company is looking for a Senior Prior Authorization Configuration SME.

Key Responsibilities

• Identify and perform quality and audit opportunities for prior authorization configuration
• Collaborate with SMEs and business partners to confirm authorization rules and assist with inquiries
• Create and maintain Standard Operating Procedures and documentation to support configuration and audits

Required Qualifications

• High School Diploma / GED or equivalent work experience
• 1+ years of audit/quality experience
• 1+ years of experience facilitating meetings
• Experience with Prior Authorization requirements and claims processing systems
• Knowledge of SQL server and applications such as Visio, PowerPoint, and Access