- Obtain prior authorization information in accordance with established guidelines.
- Must work well independently and in a team environment.
- 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.
- 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.
- Confirm new patients and return appointments in computer system in accordance with physician and/or office guidelines.
- Appropriately schedule all specialty appointments
- Coordinate transportation and interpretation services for all specialty appointments as needed.
- Follows policies and procedures to contribute to the efficiency of the office.
- Prepares correspondence, memos, forms and other typing as requested by supervisor.
- Knowledge of basic computer skills such as Microsoft Office Suite (Outlook, Word, Excel, PowerPoint, etc.)
- Must be a quick learner on various software platforms.
- Ability to effectively present information and respond to questions from management, participants, auditors and coworkers.
- Track and schedule patient referrals
- Process authorizations
- EMR experience a plus
- Health insurance experience and general knowledge preferred.
Medical Authorization Assistant - Anaheim, United States - North American Staffing Group, Inc.
Description
Job Description
Job DescriptionMedica Talent Group is excited to share this opportunity with you Our client, a well-known and reputable Healthcare Organization is seeking a Medical Authorization Assistant to join their team in Anaheim, CA
Schedule: Monday to Friday, 8AM – 5PM (Full-time)
Assignment Length: Temp – possibility of direct hire based on performance and need*
Location: Anaheim, CA
PAY: $18/HR
**MUST BE COVID VACCINATED**
Job Description
Under the supervision of the Quality Improvement Team Leader, the Authorization Specialist 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 Authorization Specialist 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:
Knowledge, Skills, and Abilities
Computer Skills
Language Skills
Essential Functions
Experience