Quality PA Clinical Float
About The Position
This position is responsible for authorization and precertification for services and medications, referral appointment scheduling, and surgery scheduling. The role also involves accurate and timely processing of prior authorizations, performing appeals as necessary, and resolving each case as assigned. This role will back up hospital medication prior authorizations and work with Pharmacy to meet 340B medical record documentation from specialists. Additionally, the position obtains medical records to close referral loops and meet qualifying measures for programs the SCCH Clinics/Hospital are required to meet, labels medical records properly within Athena, and responds promptly to patient needs. The role facilitates professional/empathetic resolutions for patients and answers prior authorization questions for patients. The Quality PA Clinical Float will also work with the Clinical Supervisor to provide requested information for projects, work in the Saturday rotation at QuickCare Clinic location, fill in as float in the clinical schedule when deemed necessary by management, and maintain/meet all Clinical skills/duties required by SCCH Clinics as an employee. Other duties as assigned.
Requirements
- Graduate from an accredited Medical Assistant Program
- Knowledge of practice operations
- Clinical experience
- Knowledge of medications
- Commitment to “cross training” assigned tasks
- Commitment to customer satisfaction in responding to all patient/customer inquiries (internal customers)
- Ability to use office equipment
- Ability to adapt to changes in procedures and/or workload
- Excellent written and oral communications skills
- Ability to work independently with little supervision
- Ability to work under pressure with time constraints
- Ability to concentrate
- Medical Assistant certification
- CPR certification
Responsibilities
- Responsible for authorization and precertification for services and medications, referral appointment scheduling, and surgery scheduling
- Responsible for accurate and timely processing of prior authorizations, perform appeals as necessary, and the ultimate resolution of each case as assigned
- Back up to hospital medication prior authorizations
- Works with Pharmacy to meet 340B medical record documentation from specialists
- Obtains medical records to close referral loops and to meet qualifying measures for programs that the SCCH Clinics/Hospital are required to meet
- Labels medical records properly within Athena.
- Responds promptly to patient needs
- Facilitates professional/empathetic resolutions for patients
- Answers prior authorization questions for patients
- Works with Clinical Supervisor to provide requested information needed for projects
- Works in the Saturday rotation at QuickCare Clinic location
- Will fill in as float in clinical schedule when deemed necessary by management
- Maintains/meets all Clinical skills/duties required by SCCH Clinics as an employee
- Performs other duties as assigned
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
