Authorization Specialist - MMF Orthopedics

Marshall Medical Center • Placerville, CA

4d • Onsite

About The Position

The Authorization Specialist is an integral member of the healthcare team and is responsible for obtaining pre-certifications and pre-authorizations for procedures, durable medical equipment and medications including any other authorizations as needed per clinic. Works with internal physician office staff, patients, providers and clinical staff to facilitate a fast and efficient authorizations process. Consistently facilitates effective communication between our patients, families, insurance companies, providers and members of the patient care support staff and participates in quality performance improvement activities to support a positive patient focused customer service experience.

Requirements

• High School Diploma or GED required
• Minimum of two years’ customer service experience preferred, preferably within a healthcare environment
• Experience working with patients and providers, using EPIC (electronic health record)
• At least one year of experience with insurance/medication authorizations preferred
• Exceptional communication and customer service skills
• Strong organizational skills
• Ability to prioritize and manage a great number of details and multi-task with strong follow through
• Ability to take initiative, learn quickly and actively participate as part of an administrative team
• Computer proficiency with MS Office Suite, including Word and excel, and Google applications, as well as an ability to learn new programs with ease
• Ability to establish and maintain effective working relationships with all levels of staff, volunteers, and the general public
• Excellent interpersonal skills and be comfortable with people in all stages of health and healing
• Adherence to HIPAA regulations and maintaining clinic, provider, RN and patient confidentiality

Responsibilities

• Obtaining pre-certifications and pre-authorizations for procedures, durable medical equipment and medications including any other authorizations as needed per clinic.
• Working with internal physician office staff, patients, providers and clinical staff to facilitate a fast and efficient authorizations process.
• Facilitating effective communication between patients, families, insurance companies, providers and members of the patient care support staff.
• Participating in quality performance improvement activities to support a positive patient focused customer service experience.
• Verifying and processing insurance eligibility and obtaining authorization requests.
• Verifying personal credentials with external partners to obtain information (e.g., ID.me for identity verification for VA insurance coordination).

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED