Urgent Hiring LOA/HMO Processor Specialist

1. Review and evaluate Letters of Authorization (LOA) requests in accordance with member eligibility and policy coverage.

2. Verify member policies, benefits, and entitlements in the system prior to authorization.

3. Approve or decline requests based on company guidelines, policy terms, and service level agreements (SLAs).

4. Handle inbound and outbound calls or emails from members, hospitals, and partners regarding policy coverage, LOA status, and related inquiries.

5. Coordinate with underwriting and claims teams for complex or exceptional cases.

6. Ensure accurate and timely documentation of all customer interactions and authorization activities.

7. Identify and escape issues, trends, or potential fraud to management.

8. Meet or exceed daily productivity and quality standards.

9. Participate in continuous process improvement initiatives and promote a positive customer experience

Job Types: Full-time, Perma...