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Clinical Authorization Specialist
2 months ago
Come work at a leading organization dedicated to providing exceptional care.
Job Overview:
Position Summary
The Clinical Authorization Specialist plays a crucial role in managing the precertification process for patients, which is essential for insurance providers. This position involves performing various administrative tasks that support both clinical and provider needs.
We welcome applications from individuals with backgrounds as medical assistants, pharmacy technicians, or other relevant clinical experience, as these skills are highly beneficial.
Key Responsibilities
- Secure necessary approvals by researching ICD-10 codes, completing authorization forms, and ensuring that all clinical information is submitted to insurance companies.
- Collaborate with staff to exchange information and receive updates regarding patient procedures and statuses. Act as a resource and educate team members on the precertification process.
- Work with Patient Accounts to address billing and precertification inquiries, providing documentation as required.
- Verify self-pay accounts and conduct research to confirm the absence of other insurance coverage.
- Develop proficiency in using current technologies, including electronic medical records and other office equipment.
- Maintain electronic files, logs, and records for efficient retrieval and accurate tracking of production.
- Ensure confidentiality regarding employee, client, and company information.
- Prepare visit charts based on daily appointments, ensuring all necessary documents are accessible to providers.
- Document interactions clearly and professionally.
- Process medication refill requests according to established guidelines.
- Communicate with patients promptly and professionally, addressing any complaints or concerns appropriately.
- Identify urgent situations and communicate them to the relevant personnel for timely intervention.
- Engage in quality and regulatory activities, fostering teamwork and professional relationships within the organization.
- Participate in ongoing education to enhance personal knowledge and skills.
- Cross-train as needed in patient service roles, including telephone coverage.
Education/Experience/Licensure
- Education: High School diploma or GED required. Completion of an accredited Medical Assistant program or equivalent clinical experience in healthcare is necessary.
- Licensure: Medical Assistant certification is preferred.
- Experience: A minimum of one year in a Medical Assistant or similar clinical role is preferred, along with experience in customer service or office settings.
What We Offer
- Comprehensive health, dental, prescription, and vision coverage for both full-time and part-time employees.
- Short-term and long-term disability insurance, along with life insurance options.
- Competitive compensation.
- Tuition reimbursement programs.
- 403(b) Retirement Savings Plan.
And more
Work Schedule:
Monday-Friday, 8am-5:00pm, 32 hours weekly.
We are an equal opportunity employer and welcome all qualified applicants without regard to race, color, religion, sex, sexual orientation, disability status, veteran status, or any other characteristic protected by law.
