Authorization Specialist - Medical Management Support

Siho Holding; Columbus (IN); On-site; USD 21,000 - 32,000; Full time

Job summary

SIHO is seeking an Authorization Specialist at our Columbus, IN location. This non-exempt role supports the Medical Management Team by handling inquiries, data entry, and general administrative tasks related to the authorization process.

Responsibilities include triaging calls, ensuring accuracy of structured data, and coordinating with various departments to meet the needs of members and providers. No clinical decisions are made in this position.

Qualifications

• High School diploma or GED required; some college preferred.
• Excellent telephone skills and professional communication.
• General knowledge of Microsoft Office software.
• Knowledge of medical terminology or willingness to learn.
• Good organizational and prioritization skills.
• Ability to effectively communicate with all SIHO customers.
• Ability to work cohesively as a member of the Medical Management team.
• Willingness to be flexible and meet department needs through changes.
• Ability to consistently meet performance requirements.
• Professional appearance and presence.
• Excellent interpersonal communication in the office environment.

Responsibilities

• Responds to telephone inquiries from physician offices.
• Enter structured clinical data into the SIHO authorization system.
• Coordinate and streamline the authorization process by screening for precertification requirements.
• Triages calls to the Medical Management Department and contacts providers for UR decisions.
• Collaborates with SIHO departments to manage member and provider needs.
• Enter authorization demographic and structured clinical data and transfer requests to clinical reviewers.
• Complete non-SIHO delegated authorization entry for claims adjudication.
• Assist in educating provider offices on Medical Management processes.
• Perform Medical Management tasks that do not require clinical evaluation.
• Obtain clinical notes and contact providers as needed for daily functions.

Skills

Telephone skills

MS Office

Medical terminology

Organizational skills

Communication skills

Team collaboration

Flexibility

Performance standards

Professional appearance

Interpersonal communication

Education

High School diploma or GED

Job description

SIHO is seeking an Authorization Specialist at our Columbus, IN location. This non-exempt role supports the Medical Management Team by handling inquiries, data entry, and general administrative tasks related to the authorization process.

Responsibilities include triaging calls, ensuring accuracy of structured data, and coordinating with various departments to meet the needs of members and providers. No clinical decisions are made in this position.