Diagnostic & Authorization Advocate

Grand Rapids Ophthalmology•Grand Rapids, MI

8d•Onsite

About The Position

The ideal candidate will have strong communication and computer skills, and as well as strong organization and attention to detail, to provide a positive impression, showing patients we provide unsurpassed care right from the start.

Requirements

High school diploma or general education degree (GED) required.
Strong communication skills.
Strong computer skills.
Strong organization and attention to detail.
Professional appearance and actions.
Logical and critical thinking skills.
Customer-focused with excellent written, listening, and verbal communication skills.
Detail-oriented, professional attitude, reliable.
Exhibits a positive attitude and flexibility in accepting work assignments and priorities.
Meets attendance and tardiness expectations.
Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills.
Interpersonal skills for customer service and team support.
Able to communicate effectively in English, both verbally and in writing.
Ability for basic to intermediate problem solving, including mathematics.
Basic to intermediate computer operation.
Proficiency with Microsoft Excel, Word, and Outlook.
Knowledge of state and federal regulations for this position.
General understanding of HIPAA guidelines.
Employees must be able to lift, carry, push, and pull items up to 25 lbs.
Strong fine motor skills and full use of hands are essential.
Constant grasping, writing/typing, hearing, and use of technology.
Visual and auditory acuity—including color, depth, peripheral vision, and the ability to adjust focus—is required 100% of the time.

Nice To Haves

Previous medical office experience preferred.
Previous ophthalmic experience strongly preferred.
Enjoys learning new technologies and systems.
Management and organizational skills to support the leadership of this function.
Occasional driving or climbing may also be necessary.
Dependable transportation and a driving record that meets company liability carrier standards (for travel to other site locations).

Responsibilities

Process prior authorizations for diagnostic procedures.
Assist patients with self-pay processes and Good Faith Estimates.
Manage patient drug assistance applications, including initial applications, renewals, and provider paperwork.
Keep track of all lab orders and results, file them in EMRs, and notify providers of new results.
Track radiology orders, ensuring compliance with national and insurance guidelines.
Verify that all necessary information, including specific ICD-10 codes, is included on imaging orders.
Collaborate with insurance portals and representatives to obtain prior authorizations for imaging orders.
Update the Nextgen lab and radiology modules with new tests and compendiums.
Connect patients needing assistance with affording eye drops to available programs.
Research affordable alternative discount programs for patients.
Ensure received eye drops are sent to the patient's preferred pick-up location or mailed if necessary.
Maintain detailed records of patient assistance participants, programs, and renewal dates.
Track which drops are shipped directly to patients and which are shipped to the practice.
Note which patients need to call for their own refills and which require the practice to order their drops.
Perform other duties as necessary for the organization.