Medical Assistant/Prior Authorizations Specialist
1 week ago
We are seeking a highly skilled and detail-oriented Medical Assistant/Prior Authorizations Specialist to join our team at Anne Arundel Dermatology. As a key member of our healthcare team, you will play a critical role in ensuring that our patients receive timely and appropriate approval for medical treatments, procedures, and medications.
Responsibilities- Review and assess prior authorization requirements for dermatology treatments, medications, and procedures.
- Initiate and complete the prior authorization process with insurance payers and primary care providers.
- Maintain positive relationships with referring primary care providers.
- Maintain detailed and accurate records of all authorization requests and outcomes.
- Ensure all patient records are up-to-date with the necessary authorization documentation.
- Collaborate closely with healthcare providers to gather necessary clinical information and documentation for authorization requests.
- Act as a liaison between the practice, patients, and insurance companies/primary care providers to provide updates on the status of authorization requests.
- Communicate authorization denials and appeals processes to healthcare providers, clinical team, and front office team.
- Stay up-to-date with insurance regulations, guidelines, and coding changes relevant to dermatology.
- Ensure that authorization requests adhere to all legal and ethical standards.
- Investigate and resolve any authorization-related issues or discrepancies.
- Assist in the appeals process for denied authorizations.
- Compile and analyze data related to authorization success rates and delays to identify areas for improvement.
- High school diploma or equivalent; additional education or certification in healthcare administration or related field preferred.
- Prior experience in prior authorization processes within a dermatology practice or healthcare setting is highly desirable.
- Phlebotomy preferred.
- Be familiar with and compliant with OSHA/HIPAA, infection control & Blood Borne Pathogen Standards.
- Experience administering injections.
- Knowledge of medical terminology, CPT and ICD-10 codes.
- Knowledge of office financial policies.
- Basic computer skills and experience in EMR utilization.
- Able to operate standard office equipment (i.e. computer, fax, copier, scanner, etc).
- Excellent verbal and written communication skills.
- Fluent in English.
- Ability to function well in a high-paced and at times stressful environment.
- Ability to work in an effective, cooperative, and courteous manner with staff, patients, and visitors.
- Ability to multi-task, prioritize appropriately, and work well both individually and as part of a team.
- Ability to read, understand and follow oral and written instruction.
- Ability to spell, sort and file materials correctly alphabetically or numerically.
Prolonged periods of sitting at a desk and working on a computer. Must be able to lift 15 pounds at times.
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