Medical Authorization Assistant

2 weeks ago


Orange, California, United States V Group Inc. Full time
About the Role:

We are seeking a highly motivated and experienced Medical Authorization Assistant to provide office and referral management support services.

The Medical Authorization Assistant will provide support to inpatient Medical Case Managers in obtaining medical records, documenting case information in the system, and performing data entry into appropriate databases.

The incumbent will serve as the contact between members, physicians, facilities, providers, and the Client staff.

The incumbent will be responsible for processing intake information and assisting with authorization functions.

Qualifications:

  • Bachelor's degree in Healthcare Administration or a related field
  • 2 years of experience in a healthcare or managed care setting
  • An equivalent combination of education and experience

Responsibilities:

  1. 85% Medical Authorization - Receives referral requests via fax, phone, or electronically and enters new service request information into the authorization system
  2. Collects additional information from Client members and providers to complete referral information
  3. Authorizes requested services according to Client's authorization guidelines
  4. Contacts the health networks and Client Customer Service regarding health network enrollments
  5. Assists the Medical Case Managers in gathering medical records, obtains appropriate coding for diagnosis and procedures, and follows up on phone calls as directed
  6. Documents all contacts and case information in the system using the standard charting format
  7. Performs data entry into the appropriate databases for monitoring, tracking, and trending of events
  8. 10% Administrative Support - Participates in a mission-driven culture of high-quality performance
  9. Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals
  10. 5% Completes other projects and duties as assigned


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