Authorization Specialist-MVP - Loma Linda, United States - Loma Linda University Medical Center

Loma Linda University Medical Center Loma Linda, United States

1 week ago

Description

Job Summary:
The Authorization Specialist-MVP tracks and initiates authorizations and re-authorizations. Accurately completes authorization requests, i.e. SAR's, TAR's and submit to insurance payer in a timely manner. Obtains pertinent documentations, i.e. history/physical, physician/progress notes, prescription, etc. to support the authorization request. Provides approved authorizations and documentation to contracted billing company and monitors when re-authorization is needed. Monitors financial hold list and supplies contracted billing service with necessary paperwork for expeditious billing. Performs other duties as needed.

Education and Experience:
High School Diploma or GED required. Minimum six months experience in a healthcare setting required. Pharmacy technician experience in infusion pharmacy preferred.

Knowledge and Skills:
Knowledge of third-party reimbursement, statistics, data analysis, and ability to speak clearly and gather information. Ability to operate copy machine, fax machine, and computer. Able to type minimum of 30 wpm. Able to communicate effectively in English, in person, in writing, and by phone, etc., with customers/patients/staff/physicians, nurses and the general public. Demonstrates excellent oral and writing skills and excellent listening skills; working as a team player to achieve LLUMC and departmental goals, ability to have others cooperate or follow a specific course of action; relate positively, effectively, and professionally with others; be assertive and consistent in following and/or enforcing policies; work calmly and respond courteously when under pressure. Able to think critically, perform basic math functions; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information; pay close attention to detail; work independently with minimal supervision. Able to maintain a high level of understanding of pharmacy home infusion/home health practices, all functions of home infusion program and the most current practices of obtaining authorization/re-authorization information and data. Able to distinguish colors as necessary; write, hear, read, and speak sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with workplace; see adequately to read computer screens, and written documents necessary to the position; discern temperature variances through touch.

Licensures and Certifications:
Pharmacy Technician Certification preferred.

Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness.

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