About The Position

The PG Authorization Clerk utilizes customer service skills and knowledge of the principles of managed care to respond to a variety of customer requests and support utilization management activities in a managed care environment. Must be able to demonstrate the abilities and skills necessary to facilitate the pre-certification of requested medical services through knowledge of clients benefits and the provider network; by providing support and education to internal and external customers, through conflict resolution and clear communication of information.

Requirements

  • Generally requires 1 to 3 years of related experience.
  • High school diploma is required.
  • Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines.
  • Ability to communicate effectively in both oral and written form.
  • Ability to handle difficult and stressful situations with critical thinking and professional composure.
  • Ability to understand and follow instructions.
  • Ability to exercise sound and independent judgment.
  • Knowledge and skill in use of job appropriate technology and software applications.
  • Valid license or certification is required as needed, based on the job or specialty.

Responsibilities

  • Schedules ancillary services and other test at facilities.
  • Inform patient the date and time of procedure.
  • Faxes authorization requests with the doctors notes attached to the insurance company.
  • Assures all requested authorizations have been approved.
  • Performs all other related job duties as assigned.
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