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Medical Authorization Specialist

1 month ago

Escondido, California, United States Pain Relief Solutions Full time
Job Summary

Pain Relief Solutions is seeking a highly organized and detail-oriented Medical Authorization Specialist to join our team. In this role, you will be responsible for coordinating referral authorizations and insurance eligibility, ensuring timely and accurate processing of patient information.

Key Responsibilities:

  1. Obtain authorization for scheduled patients and record requests in the EMR system.
  2. Run eligibility checks, correct errors, and notify supervisors of denied authorizations or eligibility issues.
  3. Utilize Cover My Meds for pharmacy medications prescribed and ECW for preferred services.
  4. Monitor and address pending claims, ensuring timely resolution.
  5. Perform other duties as assigned by management.

Requirements:

  • High school diploma or equivalent; some college preferred.
  • Minimum one year of referral/authorization experience.
  • Knowledge of medical terminology, clinic policies, and computer systems.

Working Conditions:

This position is located in a well-lighted office environment, with occasional evening and weekend work. The ideal candidate will be able to maintain confidentiality and effectively work with others.