Preauthorization Clinical Specialist LPN/RMA/CMA
About The Position
Explore opportunities with Holston Medical Group, part of the Optum family of businesses. Holston Medical Group combines the personal feel of a community-based practice with the strength, resources and career opportunities of a leading national health care organization. As a multispecialty clinic offering care across northeast Tennessee and southwest Virginia, our teams deliver high-quality, value-based care that exceeds expectations while making care easier, more affordable and more accessible. Join us and discover the meaning behind Caring. Connecting. Growing together. Pay Range: $17.37 - $26.36 General Summary: 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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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
