Preauthorization Clinical Specialist LPN CMA RMA

Holston Medical GroupKingsport, TN

About The Position

The Preauthorization Clinical Specialist is responsible for obtaining authorizations for medications prescribed by our physicians in a call center environment. This position will obtain patient information to complete insurance requirements for obtaining pre-authorization for patients’ medications.

Requirements

  • RMA,CMA or LPN
  • General understanding of medical terminology
  • Familiarity with computers and other office equipment.
  • Must possess excellent communication and organizational skills
  • Ability to work in a team environment and collaborate with others

Responsibilities

  • Interact with patients’, physicians and other staff within the offices to provide accurate, timely and responsive information
  • Obtains precertification/preauthorization from insurance companies, using an online application or by contacting insurer on the telephone.
  • Ensure efficient telephone communication
  • Maintain accurate records of what insurance require authorizations and types of medications that require an authorization.
  • Appropriate documentation of insurance approvals, denials and pending cases.
  • Maintain strict confidentiality in all matters relating to personnel and patient PHI (Protected Health Information)
  • Assist with other Call Center Activities as assigned.
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