Under the supervision of the Quality Improvement Team Leader, the Medical Authorization Assistant is responsible for all aspects of the authorization process. Responsibilities include collecting all necessary documentation, contacting the referring provider office for additional information and completion of the required prior authorization form in order to proceed with the request. The Medical Authorization Assistant will work closely with the clinical staff, claims and billing departments. Must display excellent communication, organization and follow-up skills with the ability to handle multiple assignments simultaneously. In addition, demonstrates good judgement as well as attention to detail.

Essential Job Functions

Duties include, but are not limited to:

· Obtain prior authorization information in accordance with established guidelines.

· Verify prior authorizations and/or pre-service requirements are met.

· Timely completion for all prior and retro authorization requests.

· Proactively manages and maintains all authorization requests to ensure billing of clean claims.

· Provide outstanding customer service to participants and develop and maintain positive working relationships with internal and other external customers.

· Identify and report trends and prior authorization issues relating to billing and reimbursement.

· Document all account activity and correspond to inquires in a timely manner.

· Reviews accounts on a daily basis while meeting or exceeding all daily, weekly and monthly production goals.

· Responsible for documenting authorization status and demonstrating proficiencies with software systems and electronic health records.

· Identifies prior authorization trends and/or issues resulting in delayed processing.

Experience

· EMR experience a plus

· Health insurance experience and general knowledge preferred

Knowledge, Skills, and Abilities

· Communicates and works effectively with colleagues from other departments.

· Follows written and verbal communications.

· Follows all health and safety policies and procedures.

· Performs other related duties as required or assigned.

· Appropriately schedule all specialty appointments

· Follows policies and procedures to contribute to the efficiency of the office

· Prepares correspondence, memos, forms and other typing as requested by supervisor

Computer Skills

· Knowledge of basic computer skills such as Microsoft Office Suite (Outlook, Word, Excel, PowerPoint, etc.).

· Must be a quick learner on various software platforms

Language Skills

· Ability to effectively present information and respond to questions from management, participants, auditors and coworkers.

Essential Functions

· Track and schedule patient referrals

· Process authorizations

This position is Monday-Friday 8am-5pm in-person

Covid status: Booster required or if no booster, testing weekly is required. Beginning March, testing twice per week will be required if no booster.

Job Types: Full-time, Contract

Pay: $18.00 per hour

Schedule:

• 8 hour shift
• Monday to Friday
• No weekends

Education:

• High school or equivalent (Preferred)

Experience:

• Insurance verification: 1 year (Preferred)
• Healthcare Setting: 1 year (Preferred)
• EMR systems: 1 year (Preferred)
• Microsoft Office Suite: 1 year (Preferred)

Work Location: One location