Prior Authorization Specialist - Marietta, United States - SPCP/Southeast Medical Group

Description

Job Description

We are seeking a skilled and detail-oriented individual to fill the role of Primary Care Prior Authorization Specialist. The primary responsibility of this position is to work with primary care physicians to obtain prior authorization for medical procedures and treatments. The successful candidate will work closely with the physician, the patient, and the insurance provider to ensure that all necessary approvals are obtained in a timely and efficient manner.

Prior Authorization Specialist- Medical Assistant

SEMG Medical Assistant Job Description

Join Our Exceptional Healthcare Team

Are you a medical assistant who is looking for a job that offers a supportive and collaborative work environment? Look no further

At Southeast Medical Group, we are a team of dedicated and compassionate healthcare professionals who are committed to providing exceptional care for our patients. We are looking for a medical assistant who shares our values and is ready to join us in delivering top-notch care. As our new medical assistant, you will have the opportunity to:

Work closely with our primary care physicians and other healthcare professionals to provide high-quality care to our patients.

Assist with a wide range of tasks, including scheduling appointments, taking vital signs, and preparing patients for exams.

Contribute to a positive and team-oriented work environment.

Enjoy competitive compensation and benefits, as well as opportunities for professional development and growth.

To be successful in this role, you should have a background in medical knowledge of:

Medication Prior Auth

Buy and Bill vs. inhouse billables.

Knowledge of Cover My Meds

Knowledge of Transact RX

MA/ Provider Inbox management

Care gap lists from Insurance vendors.

MCAWE care gap closures

Medical assistant certification

Experience in a medical office setting.

Excellent communication and interpersonal skills

A commitment to excellence and a willingness to learn and grow.

If this sounds like the right job for you, we want to hear from you Please send your resume and a brief note about why you would be a great fit for our team. We can't wait to meet you

Certified Medical Assistant-1

Responsibilities

Receive and direct phone calls, obtain necessary patient information to file and update patient records, and ensure all forms and consents are completed by patients.

Performs a variety of patient care activities to assist physicians and nursing personnel.

Delivers quality customer service and maintains established quality control standards.

Check-out patients, assist with referral processing, and arrange laboratory services.

Prepare patients for examination, take vitals, and record patients' health history.

Set-up EKG machines and other ancillary tests, administer injections and medications, and perform routine specimen collection and tests.

Prepare equipment and examination rooms, and clean instruments.

Assist physician with medical treatments, procedures, and exams.

Manage inventory of medical supplies and equip exam rooms with appropriate supplies.

Managing messages, prior authorizations, patient calls

Qualifications

High school diploma or GED required; completion of an accredited medical assistant certification program at time of hire (w/certification), or within 180 days of employment.

Excellent interpersonal skills

Maintains MA and CPR certifications (and actions required for recertifications) (CPR within 30 days of employment)

Ability to always communicate clearly and effectively with patients and other external parties in a courteous and friendly manner

Knowledge of medical terminology

Must be detail-oriented and highly organized.

Firm grasp on medical practices, administrative processes, and organizational policies

Knowledge of patient care and examination procedures

Must be able to maintain confidentiality at all times.

Certified Medical Assistant-2

Responsibilities

Perform all responsibilities for MA-1

Assist in training and evaluation of new hires

Assist in inventory management process

Pod leader responsibilities

Assisting other MAs and providers in need

Assisting MA-Team Lead as directed

Maintain all logs and required checks (refrigerator temperatures, emergency medications, expired medications, oxygen, cold sterilization fluid change, etc.).

Review charts, lab test results, and encounter forms for completeness and to assess follow-up as needed.

Assists with daily and monthly quality assurance reviews including emergency kit check off.

Certified Medical Assistant-3

Responsibilities

Perform all responsibilities of MA-2

Assist in re-evaluation and retraining process for MAs on PIP or other competency improvement plans

Make sure early and late MA schedules are set

Assist practice manager on clinical tasks as directed

Maintain inventory of medical supplies – order, receiving, and returning

Assist with patient complaints as needed

Guide patients and clinical staff to the proper authority for any issues

Assist with clinic scheduling problem solving, patient wait times, and other areas of concern to increase efficient and quality services.

Manage and maintain ortho supply and medication samples closets

Certified Medical Assistant-Team Lead

Responsibilities

Perform all responsibilities of MA-3

Assist in the supervision of work and performance of clinic staff, medical assistants and other support staff, as instructed, including input for performance reviews and corrective action plans as needed.

Assist with interviewing new MA candidates and providing input

Oversee and train new and existing staff along with the clinic manager.

Assist with intake and set-up for patient visits.

Assist with the training of medical and lab assistants, and volunteer staff on health education, laboratory, and dispensary services. Assist in providing on-going supervision to same staff.

Assist as needed including medication refill requests, specialty and procedure referrals, pre and post clinic chart review.

Review charts, lab test results, and encounter forms for completeness and to assess follow-up as needed.

Perform other administrative tasks and clinical care as assigned by the Clinic Manager.

Work with Manager to oversee dispensary logs and storage to maintain quality assurance.

Coordinate the inventory, ordering and supply stock maintenance of medical supplies.

Assist with other administrative projects and tasks as needed.

Assists with daily and monthly quality assurance reviews including emergency kit check off.

Performs other duties as assigned by management.

Team leads are the first chain in the management ladder.

Arranges staff to best manage patient flow.

Handles problems and complaints from staff members.

Any situations that are beyond the team leads abilities will be escalated up to the manager for resolution.

Team leads are responsible for their assigned MAs. Duties include ensuring MA tasks are completed and ensuring MA credentials are up to date (with Training and Education assistance).