Clinical Support Specialist / Medical Assistant

Hunter Health•Wichita, KS

12d•Onsite

About The Position

Hunter Health provides all-encompassing care for the Wichita community, including medical, dental, behavioral, vision, laboratory, radiology and pharmacy services, all in one place. We pride ourselves in providing the support patients need to take control of their health and their whole wellbeing. Our Hunter Health team is at the heart of our operations. From the initial interaction with a new patient to empowering individuals with the knowledge to manage their health - it begins with each member of our staff. Regardless of role or responsibility, every team member is a valuable part of living our mission and upholding our positive work environment with our Standards of Culture. We exist to improve the health and wellbeing of everyone in our community.

Requirements

Experience with determining insurance eligibility, managing referrals and prior authorization is required.
Knowledge of medical terminology and ambulatory clinical workflows is required.
Proficiency in electronic health records and Microsoft Office applications is required.
Current Basic Life Support (BLS) is required, within 30 days of hire.

Nice To Haves

Basic knowledge in CPT and ICD-10 code preferred.
Certified or Registered Medical Technician, Medical Assistant and/or Certified Nurse Assistant is preferred.
1-3 years of experience in healthcare is preferred, with experience in a community health center is also preferred.
Bilingual abilities are preferred but not required.

Responsibilities

Coordinates prior authorizations for medications, imaging, procedures, durable medical equipment (DME), specialty services, and other payer-required services, ensuring requests are complete, accurate, and submitted within required timeframes.
Monitors authorization requests, follows up with insurance carriers, communicates approval or denial outcomes to providers, staff, and patients, and coordinates appeals when appropriate.
Assists with coordination of referrals to specialists, diagnostic testing, therapy services, and community resources, obtaining required authorizations, transmitting documentation, tracking referral completion, and ensuring records are incorporated into the electronic health record (EHR).
Manages assigned telephone encounters, electronic messages, and provider inbox workflows by resolving appropriate administrative requests, routing clinical concerns to licensed staff, documenting patient communications, and maintaining established service standards.
Assists with processing prescription refill requests in accordance with organizational procedures by reviewing requests for completeness, coordinating with pharmacies, and communicating refill status and follow-up instructions to patients.
Verifies patient insurance eligibility, benefits, coverage, and authorization requirements while educating patients on insurance processes and collaborating with Revenue Cycle staff to resolve coverage or reimbursement issues.
Coordinates and receives external medical record requests to further assist with scheduling diagnostic testing and specialty appointments
Supports continuous improvement in quality, care coordination, and workflow initiatives through patient interactions, documentation management, and identification of opportunities to improve efficiency, provider support, and patient access.
Maintain accurate and timely documentation of authorizations, referrals, patient communications, and clinical support activities.
Develops and maintains collaborative working relationships with providers, nurses, Medical Assistants, Pharmacists, Integrated Care Consultants, Revenue Cycle staff, insurance carriers, and community partners, while providing exceptional patient care.
Participates in departmental meetings, organizational initiatives, required education, and compliance training.
Travels when necessary to meet organizational needs.
Performs all other duties as assigned.