Medical Authorization Specialist-Gastroenterology

University of Maryland Faculty Physicians • Bel Air, MD

46d

About The Position

Under general supervision, performs all medication prior authorizations as needed. Ensures that referral and pre-authorization activities are undertaken in order to provide maximum patient and provider satisfaction and maximum reimbursement; and other duties as assigned. ESSENTIAL FUNCTIONS Confirms insurance and demographic information is correct and accurate. Maintains knowledge of all payers' guidelines. Reviews and extracts medical records to support medical necessity. Follows up to ensure all documentation is accurate and present. Works with patients, physicians and payers to resolve any denial issues. Note: The intent of this list of primary duties is to provide a representative summary of the major duties and responsibilities of this job. Incumbents perform other related duties as assigned. Specific duties and responsibilities may vary based upon departmental needs.

Requirements

• High school diploma or general education degree
• Two years related medical office experience
• Accurate data entry skills
• Current knowledge of payer requirements for referrals and preauthorization
• Knowledge of GE/IDX or similar computerized billing system
• General understanding of back-office operations
• Strong customer service skills
• PC proficiency

Nice To Haves

• Medical terminology preferred

Responsibilities

• Confirms insurance and demographic information is correct and accurate.
• Maintains knowledge of all payers' guidelines.
• Reviews and extracts medical records to support medical necessity.
• Follows up to ensure all documentation is accurate and present.
• Works with patients, physicians and payers to resolve any denial issues.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees