Client Services Analyst I

Job Summary

A company is looking for a Client Services Analyst I who will manage prior authorization and referral requests for state Medicaid members.

Key Responsibilities

• Process prior authorization/referral requests and verify the accuracy of submitted medical documents
• Monitor compliance with legal and regulatory requirements, including HIPAA and CMS guidelines
• Update patient information in systems to ensure timely claims payment and achieve quality and productivity KPIs

Required Qualifications

• High School Diploma or GED required
• Minimum of 3 years of client service experience
• Healthcare industry experience preferred
• Exposure to SQL Server or reporting tools preferred
• Strong analytical skills with a focus on data accuracy and quality