Medical Authorization Specialist

Bioventus•Memphis, TN

27d

About The Position

As a Medical Authorization Specialist (MAS) you will support the reimbursement strategy of the company by aggressively pursuing authorization and reimbursement while establishing a resource of expertise to the payers. You will need to demonstrate, through actions, a consistent performance standard of excellence to which all work is to conform.

Requirements

High school diploma plus 4 years of related experience or 4-year college degree
1 year medical authorization experience involving medical record review required.
Knowledge and interpretation of medical terminology and ICD-10 coding.
Must possess good written and oral communication skills with the ability to interface with customers and company personnel at all levels.
Strong persuasion/negotiation skills.
Must display professional persistence, manage detailed information; maintain high level of organization; display strong proficiency in multi-tasking by effectively managing time and priorities.
PC experience in Microsoft Word, Excel, Outlook or other related software required.

Nice To Haves

Knowledge of SAP or other integrated software applications preferred.

Responsibilities

Reviews and interprets medical record documentation for patient history, diagnosis, and previous treatment plans.
Utilizes payer-specific approved criteria to determine medical necessity or the clinical appropriateness for the company’s products.
Submits pertinent demographic and supporting clinical documentation with pre-authorization requests timely to avoid unnecessary delays in patient treatment.
Maintains and documents complete, timely, and accurate patient insurance and billing information.
Performs on-going check and balance system to ensure the integrity of the patient billing data.
Operates compliantly at all times by keeping patient data secure and confidential and adhering to all company policies and procedures.
Works with the Order Management team to secure any additional information and medical documentation from the patient and/or prescribing HCP.
Complies with all health, safety and environmental policies, procedures and job hazard analyses applicable to specified job activities; including medical evaluations as required by job function.
Completes all required training in a satisfactory and timely manner.
Holds oneself and others accountable to conduct business in a manner compliant with Bioventus’ Code of Compliance, policies and procedures and internal controls applicable to their role.
Other duties as assigned