Authorization Specialist- MMF Family Medicine PV

MMC001 Marshall Medical Center; United States; On-site; USD 29,000 - 33,000; Full time

Job summary

Marshall Medical Center seeks an Authorization Specialist for our MMF Marshall Family Medicine clinic. This role obtains pre-certifications, pre-authorizations for procedures, durable medical equipment and medications, coordinating with providers, staff and patients to streamline the authorization process.

You will verify insurance eligibility, ensure HIPAA compliance, and support quality improvement efforts.

Qualifications

• High School Diploma or GED required.
• Minimum two years’ customer service experience, preferably in healthcare.
• Experience with EPIC EMR and insurance/authorization workflows preferred.
• Strong communication and organizational skills; ability to multitask and prioritize.

Responsibilities

• Obtain pre-certifications and pre-authorizations for procedures, DME, and medications.
• Coordinate with clinic staff, patients, providers, and insurers to facilitate authorizations.
• Verify insurance eligibility and process authorization requests, including identity verification where needed.
• Support quality improvement activities and maintain HIPAA-compliant processes.

Skills

Customer service

Communication

Organization

Multi-tasking

HIPAA compliance

Education

High School Diploma or GED

Tools

EPIC EMR

MS Office Suite

Word

Excel

Google Apps

Job description

Department: MMF Marshall Family Medicine - PV Shift: Primarily Days (United States of America) Employee Type: Regular Per Diem Type (if applicable): Minimum Pay Range: $21.00 - $24.15 Job Description:

POSITION SUMMARY

The Authorization Specialist is an integral member of the healthcare team and is responsible for obtaining pre-certifications and pre-authorizations for procedures, durable medical equipment and medications including any other authorizations as needed per clinic. Works with internal physician office staff, patients, providers and clinical staff to facilitate a fast and efficient authorizations process. Consistently facilitates effective communication between our patients, families, insurance companies, providers and members of the patient care support staff and participates in quality performance improvement activities to support a positive patient focused customer service experience.

POSITION QUALIFICATIONS

Education/Licensure/Certification: High School Diploma or GED required Knowledge: A minimum of two years’ customer service experience preferred, preferably within a healthcare environment preferred Experience working with patients and providers, using EPIC (electronic health record) At least one year of experience with insurance/medication authorizations preferred Skills: Requires exceptional communication and customer service skills, strong organizational skills, ability to prioritize and manage a great number of details and multi-task with strong follow through are mandatory. Ability to take initiative, learn quickly and actively, participate as part of an administrative team also required. Computer proficiency with MS Office Suite, including Word and excel, and Google applications, as well as an ability to learn new programs with ease Must have the ability to establish and maintain effective working relationships with all levels of staff, volunteers, and the general public. Must possess excellent interpersonal skills and be comfortable with people in all stages of health and healing. Must adhere to HIPAA regulations and maintain clinic, provider, RN and patient confidentially Comfortable with regularly verifying and processing insurance eligibility and obtaining authorization requests, including verifying personal credentials with external partners to obtain this information (e.g., ID.me for identity verification for VA insurance coordination).

A NONPROFIT HEALTHCARE PROVIDER IN EL DORADO COUNTY

Marshall is a nonprofit community healthcare provider located in the heart of the Sierra Foothills. Our history stems back to 1956, when the community banded together to build a modern hospital for El Dorado County. Since opening our doors in 1959, Marshall has been proud to maintain our status as an independent hospital whose governance remains local. Our mission is to improve the health of our community and offer health services of superior value and quality, centered on the goals and needs of our patients. We strive to deliver service that exceeds our patients’ expectations. Quality Care Marshall is routinely recognized in the top tier of hospitals in California by independent consumer healthcare groups, and we’re always striving to improve. Marshall’s Emergency Department is a verified Level III Trauma Center and our Stroke Program is not only distinguished as a Primary Stroke Center by the Joint Commission but also earned a Gold–Plus designation from the American Heart/American Stroke Association. Marshall’s Birth Center was also designated by the World Health Organization and UNICEF as a Baby Friendly certified facility for breastfeeding advocacy. Serving El Dorado County & Surrounding Areas Marshall includes Marshall Hospital, a fully accredited acute care facility with 111 beds located in Placerville; several outpatient facilities in Cameron Park, Placerville, El Dorado Hills, and Georgetown; primary and specialty care clinics, more than 190 affiliated physicians and providers, as well as a team of more than 1,600 employees providing quality healthcare services to residents of El Dorado County. Marshall’s executive leadership is governed by a local board of directors who volunteer their time to represent the needs and interests of a growing community. Marshall also has a dedicated group of Auxiliary members, adult and junior volunteers that lend their support.