PCP Prior Authorization Specialist
4 days ago
About Us
One Medical is a primary care solution challenging the industry status quo by making quality care more affordable, accessible and enjoyable. But this isn't your average doctor's office. We're on a mission to transform healthcare, which means improving the experience for everyone involved - from patients and providers to employers and health networks. Our seamless in-office and 24/7 virtual care services, on-site labs, and programs for preventive care, chronic care management, common illnesses and mental health concerns have been delighting people for the past fifteen years.
In February 2023 we marked a milestone when One Medical joined Amazon. Together, we look to deliver exceptional health care to more consumers, employers, care team members, and health networks to achieve better health outcomes. As we continue to grow and seek to impact more lives, we're building a diverse, driven and empathetic team, while working hard to cultivate an environment where everyone can thrive.
The Opportunity: Being part of the One Medical centralize team is a dynamic workspace, powered by teams who are passionate about the One Medical Mission, providing world class service experiences for patients, and who are never satisfied with the status quo. Our teams thrive while handling high volume tasks, and are always evaluating their work through the lens of process improvement through continuous learning and experimentation. As an Advanced Tasking team member, you'll be a part of a specialized team, skilled in complex tasking.
Finally, in an effort to promote continuous learning and discovery, you'll be expected to motivate your team members to analyze their work closely, ask questions and seek out more efficient processes and opportunities for elevation through process improvement work, using lean tools and methodologies. This role supports patients nationwide.
There are 3 categories of Advanced Tasking:
* Complex Tasking
* Consult Orders (Specialist Office Visits) Procedure Orders (Ex: MRI/CTs, Radiology, DME, Mammogram, etc.) Prescription Authorization (Ex: High Cost Specialty Medications) Provider Support Room (Ex: Clinically Urgent Tasks for IOPs/VMT Providers)
* Sexual Reproductive Health - assisting a patient through the authorization, scheduling and coordination of complex female health procedures. (Ex. Colposcopy)
What you'll likely work on:
* Maintaining service level agreements in complex insurance authorizations.
* Meeting or exceeding performance requirements for 6 months minimum (200+ Tasks/week).
What you'll need:
* At least 2 years of experience completing referrals and navigating complex insurance portals and highly complex orders
* Experience working in a highly productive department with strong metrics accountability/ownership
* Positive, collaborative attitude and high team engagement with an action-oriented mindset.
* Working in a national market/healthcare organization that understands complexity of regions
* Experience with working with different EMRs
* Experience with working remotely preferred
Benefits designed to aid your health and wellness:
Taking care of you today
* Employee Assistance Program - Free confidential advice for team members who need help with stress, anxiety, financial planning, and legal issues
* Competitive Medical, Dental and Vision plans
* Free One Medical memberships for yourself, your friends and family
* Pre-Tax commuter benefits
* PTO cash outs - Option to cash out up to 40 accrued hours per year
* Competitive salary: the base pay for this position is $24.00 per hour based on a full time schedule
Protecting your future for you and your family
* 401K match
* Opportunity to participate in company equity programs
* Credit towards emergency childcare
* Extra contributions toward maternity and paternity leave
* Paid Life Insurance - One Medical pays 100% of the cost of Basic Life Insurance
* Disability insurance - One Medical pays 100% of the cost of Short Term and Long Term Disability Insurance
This is a full-time hourly role, with flexible shift needs that may include nights and weekends. The role is in-person in our office in Tempe, AZ.
Physical Demands: Mostly sedentary work duties require exerting up to ten pounds of force occasionally and/or small amounts of force frequently. Sedentary work typically involves sitting most of the time, but may involve walking or standing for brief periods.
One Medical is an equal opportunity employer, and we encourage qualified applicants of every background, ability, and life experience to contact us about appropriate employment opportunities.
One Medical participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. Please refer to the E-Verification Poster ( English / Spanish ) and Right to Work Poster ( English / Spanish ) for additional information.
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