Authorization Specialist/Medical Support Associate

1 week ago


Poway, California, United States Pain Relief Solutions Full time
Job Overview

Salary Range: $19 - $20 per hour

About Us: At Pain Relief Solutions, we are committed to providing exceptional patient care within a collaborative and engaging team environment. We are currently seeking a dedicated Authorization Specialist/Medical Support Associate to enhance our operations and ensure timely patient services.

Position Summary: This nonexempt role is pivotal in managing referral authorizations and verifying insurance eligibility.

Key Responsibilities:

  1. Secure authorization for all scheduled patients, ensuring proper documentation in the EMR system.
  2. Process authorizations for outgoing referrals, with a preference for candidates familiar with Cover My Meds for prescribed pharmacy medications. Experience with ECW is advantageous.
  3. Conduct eligibility checks, rectify discrepancies, and inform supervisors of any denied authorizations or eligibility issues. Maintain records of all manual communications.
  4. Generate reports 48 hours in advance to confirm no authorizations have been overlooked.
  5. Provide coverage for patient check-in as needed.
  6. Review all accounts under management to identify and address any pending claims.
  7. Perform additional duties as assigned.

Qualifications:

Education: High school diploma or equivalent; some college coursework is preferred.

Experience: A minimum of one year in referral or authorization roles is required.

Additional Requirements: None specified.

Performance Expectations:

Knowledge:

  1. Familiarity with medical terminology.
  2. Understanding of clinic policies and procedures.
  3. Proficiency in computer systems, software applications, and spreadsheet tools.

Skills:

  1. Effective oral and written communication abilities.
  2. Strong time management and organizational skills.

Abilities:

  1. Capacity to maintain confidentiality of sensitive information.
  2. Ability to collaborate effectively with colleagues.

Equipment Utilized: Standard office equipment, including computers, fax machines, copiers, printers, and telephones.

Work Environment: This position is based in a well-lit office setting, with occasional evening and weekend responsibilities.

Mental/Physical Demands: The role involves sitting for approximately 90% of the workday, with walking or standing for the remainder.



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