Surgery Scheduler/ Medical Prior Authorization Specialist

JOB DESCRIPTION

Title: Authorization Specialist Representative

JOB SUMMARY

The authorization position is responsible for all authorizations in relation to services provided by MD Pain providers.

ESSENTIAL FUNCTIONS

• Determine if authorization is required for ordered services.
• Reviews procedure requests for authorization needed based upon insurance standards while drawing upon experience and general knowledge. Reviews documentation or contacts the provider when necessary to supplement the order to prove medical necessity.
• Ensures appropriate documentation is available and complete before submitting the authorization to the insurance company to avoid repetitious submissions and denials.
• Submits all authorizations with correct CPT and diagnosis codes.
• Cross-references the procedure tasked against the doctor’s orders to ensure all services are submitted for correctly.
• Enters any authorization numbers and expiration dates into the task messages which are required for corresponding services.
• Additional duties as assigned.

REQUIREMENTS

Education & Experience, Knowledge/Understanding

• High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience

Skills

• Excellent oral, written, and listening communication skills.
• Effective organization and time management skills with the ability to manage multiple task simultaneously and work in high-pressure situations
• Excellent interpersonal skills and demeanor
• Proficient in the use of a PC; in a Windows environment; in the use of the Internet; and in the use of MS Office Applications such as Outlook, Word and Excel
• Proficient in the use of EMR systems such as Aprima

Abilities

• Ability to adhere to strict attendance and punctually expectations
• Ability to attend to details ensuring accuracy in a timely manner
• Ability to work both independently, as well as collaboratively
• Ability to identify and proactively solve problems
• Ability to thrive in a patient-focused environment
• Ability to demonstrate MD Pain’s core values and performance principles of leadership, integrity, kindness, excellence, and service

Physical Demands

• Occasionally required to stand, walk, sit, use hands and fingers, talk and hear
• Occasionally lift and/or move up to 25 pounds
• Specific vision abilities include close vision, distance vision, depth perception and the ability to adjust focus
• The noise level of the work environment is usually moderate

PREFERENCES

• Previous experience in medical professional atmosphere
• Proficient with government and private insurance
• Knowledge of medical and insurance terminology, EMR

Job Type: Full-time

Pay: From $23.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Willingness to travel:

• 25% (Preferred)

Work Location: In person