Medical Authorization Specialist -Gastroenterology

PACT and PACT MSO•Hamden, CT

25d•Onsite

About The Position

PACT MSO, a Management Service Organization supporting numerous physician groups, is seeking a Medical Authorization Specialist for its busy Gastroenterology office in Hamden, Connecticut. The position obtains and ensures pre-authorizations are completed effectively, accurately, and efficiently. The specialist compiles and communicates clinical and demographic information to insurance companies, enters authorizations into applicable databases, retrieves records and test results needed before procedures, and helps patients navigate referral and authorization processes. The role also includes entering patient information in the EHR, obtaining pre-op clearances, preparing procedure estimates, scheduling office visits, and covering the front desk as needed. The position works Monday through Friday, with eight-hour shifts between 8:00 a.m. and 4:30 p.m. PACT MSO describes itself as a medium-sized company with a family atmosphere and offers health benefits and paid time off. Proof of annual flu vaccination is required for all employees. The posted pay range is $23.00–$28.00 per hour; the rate varies based on factors including experience, skills, knowledge of the position, and comparison with others in the role.

Requirements

High school diploma or equivalent.
At least 5 years of experience obtaining authorizations.
Intermediate computer skills, including MS Office.
Understanding of authorization processes and procedures.
Knowledge of EHR systems.
Attention to detail.
Collaboration skills.
Proficient communication skills.
Proof of annual flu vaccination is required for all employees.

Responsibilities

Obtain authorizations or referrals.
Contact insurance companies, laboratories, and other parties to obtain proper authorization.
Analyze information required to complete pre-authorizations with insurance carriers and service-area contacts.
Compile and communicate accurate, pertinent clinical data and demographics to patients’ insurance companies in a timely, organized manner.
Communicate information appropriately, accurately, and promptly.
Enter necessary authorizations into applicable databases.
Retrieve medical records and critical information from referring providers before patient procedures; obtain required laboratory results, imaging results, and medical records as needed.
Collaborate with other staff to ensure appropriate insurance information is obtained.
Inform patients of their referral and authorization responsibilities.
Help patients navigate the system.
Develop tools to assess patient referral processes for efficiency and customer service.
Enter patient demographic and other identifying information into the EHR.
Obtain pre-op clearances from provider offices.
Cover the front desk as needed.
Prepare estimates for patient procedures.
Schedule office visits.