Shire Jobs

Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you!

This position is responsible for obtaining and managing authorizations for medical services, ensuring compliance with insurance requirements, and facilitating seamless patient care. This role will collaborate with healthcare providers, insurance companies, and internal teams to streamline the authorization process and enhance the overall efficiency of services.

You will…

• Initiate and complete the authorization process for medical services; respond within a pre-established timeline for requests for information or supporting documentation.

• Verify patient insurance coverage and determine the specific authorization requirements for each case.

• Handle complex medical service authorization requests, requiring a deeper understanding of medical procedures and insurance policies.

• Assess and determine the specific authorization requirements for specialized cases.

• Obtain accurate and detailed information to investigate all payment sources, documents and/or files information appropriately.

• Collaborate with insurance companies to obtain and confirm authorization details.

• Maintain accurate and organized records of all authorization requests and approvals.

• Verify eligibility monthly or as needed with all insurance carriers.

• Conduct regular audits to identify areas for improvement and ensure compliance with standards.

• Develop stronger relationships with insurance companies and internal teams to facilitate the authorization process.

• Identify and address any issues or discrepancies in the authorization process promptly.

• Collaborate with internal teams to resolve authorization-related challenges and ensure timely resolution.

• Participate in other projects or duties as assigned.

We are interested in speaking with individuals with the following…

• High School Diploma required.

• One (1) plus years of experience in insurance, billing, book-keeping, claims processing, or related field.

• Experience in the medical environment a plus.

• Or equivalent combination of education and/or experience.

• Strong attention to minute details and accuracy of a project or task.

• Strong problem-solving and critical-thinking skills.

• Excellent verbal and written communication skills.

• Strong organizational abilities.

• Demonstrated ability to follow the systematic method of performing a task.

• Demonstrated ability to utilize the available time to organize and complete work within given deadlines.

• Proficient with Microsoft Office, specifically Excel.

Salary: $18.00-$23.00/Hour

Modivcare’s positions are posted and open for applications for a minimum of 5 days. Positions may be posted for a maximum of 45 days dependent on the type of role, the number of roles, and the number of applications received. We encourage our prospective candidates to submit their application(s) expediently so as not to miss out on our opportunities. We frequently post new opportunities and encourage prospective candidates to check back often for new postings.

We value our team members and realize the importance of benefits for you and your family.

Modivcare offers a comprehensive benefits package to include the following:

• Medical, Dental, and Vision insurance

• Employer Paid Basic Life Insurance and AD&D

• Voluntary Life Insurance (Employee/Spouse/Child)

• Health Care and Dependent Care Flexible Spending Accounts

• Pre-Tax and Post --Tax Commuter and Parking Benefits

• 401(k) Retirement Savings Plan with Company Match

• Paid Time Off

• Paid Parental Leave

• Short-Term and Long-Term Disability

• Tuition Reimbursement

• Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)

Modivcare is an Equal Opportunity Employer.

• EEO is The Law - click here for more information (https://www.eeoc.gov/laws-guidance)

• Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

• We consider all applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, handicap or disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law. If you need assistance, please reach out to us at hr.recruiting@modivcare.com

Our goal isn’t a number. It’s a difference.

Modivcare is leading the transformation to better connect people with care, wherever they are. We serve the most underserved by facilitating non-emergency medical transportation (https://www.modivcare.com/offerings/nemt) and personal and home care (https://www.modivcare.com/offerings/personal-care) to enable greater access to care, reduce costs and improve outcomes.

Please note, Modivcare will never ask any potential applicant for employment for any Personal Identifiable Information via social media. Additionally, Modivcare will never ask any applicant for money. Please be cautious of any individual posing as a recruiter for Modivcare requesting personal identifiable information. If you suspect someone is attempting to collect your personal information or solicits money from you via any social media platform, we encourage you to report such scammers to that platform.

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