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

Loma Linda University Medical Center Redlands, United States

1 week ago

Description

Job 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.

About Us

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.

About the Team

Loma Linda University Health is a Seventh-day Adventist, faith and values based Christian institution. Candidates must understand and embrace the mission, purpose, and identity of Loma Linda and its affiliated entities.

We are an equal opportunity employer committed to the principles of diversity.

We provide equal opportunities in all aspects of the employment process to every individual, regardless of gender, race, color, age, national origin, ancestry, physical or mental disability, marital or veteran status, genetic information or any other characteristic protected by law.

In addition, we will provide reasonable accommodations for otherwise qualified individuals requesting an accommodation due to a disability. If you need accommodation assistance with accessing our job listings or completing an application, or during any other phase of employment with us, please contact Human Resources Management at

Loma Linda University Medical Center is a religiously-qualified Equal Opportunity Employer under Title VII of Civil Rights Act of 1964.

No question on this application is asked for the purpose of unlawfully limiting or excluding any applicant's consideration for employment because of race, color, religion, gender, age, national origin, disability, genetic information, or any other status protected by applicable law.

If you need a reasonable accommodation in the hiring process, please notify Human Resource Management.

We appreciate your interest in Loma Linda and wish you success in your job search

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