Medical Authorization Associate

Physicians-Alliance-of-Ct-; West Haven (CT); On-site; USD 25,000 - 39,000; Full time

Job summary

PACM, Inc. in West Haven, CT is seeking a Medical Authorization Associate for our busy primary care office. The role ensures pre-authorizations are completed accurately and efficiently, with hours Monday–Friday 8:30am–5pm.

You will obtain authorizations, communicate with insurance carriers, gather records, input data into the EHR, and support front desk coverage as needed, helping patients navigate the referral process.

Qualifications

• Requires high school diploma or equivalent.
• Minimum 5 years of experience obtaining authorizations.
• Knowledge of authorization processes and EHR systems.

Responsibilities

• Obtain authorizations or referrals.
• Analyzes information required to complete pre-authorizations with insurance carriers and service area contacts.
• Accurate and pertinent clinical data and demographics is compiled and communicated to the patient’s insurance company in a timely and organized fashion.
• Communicate information appropriately, accurately, and timely.
• Enters necessary authorizations into applicable database.
• Retrieves medical records and critical information from referring provider(s) prior to patient procedures; ensures that all necessary laboratory, imaging test results, and medical records are obtained if needed.
• Collaborates with other staff members to ensure appropriate insurance information is obtained.
• Inform patients of their referral/authorization responsibilities.
• Advocates for patients by helping them navigate through the system.
• Develops tools to assess patient referral processes with respect to efficiency and customer service.
• Patient demographic and additional identifying Enter patient information in EHR
• Obtain pre-op clearances from provider offices
• Cover front desk as needed
• Prepare estimates for patient procedures
• Schedule office visits

Skills

Authorization process

EHR knowledge

Education

High School Diploma or equivalent

5+ years of experience obtaining authorizations

Job description

Job Category: Administrative Support for Medical Practices

Requisition Number: MEDIC001845

• Full-Time
• On-site

Locations

Showing 1 location

PACT and PACT MSO Primary Care West Haven
West Haven, CT 06516, USA

Description

PACT MSO has a busy Primary Care office that is seeking a Medical Authorization Associate. The position obtains and assures that all pre-authorizations are completed effectively, accurately, and efficiently. The hours are Monday-Friday, 8:30am-5pm in West Haven.

Essential Functions

• Obtain authorizations or referrals
• Analyzes information required to complete pre-authorizations with insurance carriers and service area contacts.
• Accurate and pertinent clinical data and demographics is compiled and communicated to the patient’s insurance company in a timely and organized fashion.
• Communicate information appropriately, accurately, and timely
• Enters necessary authorizations into applicable database.
• Retrieves medical records and critical information from referring provider(s) prior to patient procedures; ensures that all necessary laboratory, imaging test results, and medical records are obtained if needed.
• Collaborates with other staff members to ensure appropriate insurance information is obtained.
• Inform patients of their referral/authorization responsibilities.
• Advocates for patients by helping them navigate through the system.
• Develops tools to assess patient referral processes with respect to efficiency and customer service.
• Patient demographic and additional identifying Enter patient information in EHR
• Obtain pre-op clearances from provider offices
• Cover front desk as needed
• Prepare estimates for patient procedures
• Schedule office visits

Skills and Knowledge

• Understands authorization process and procedures
• Demonstrates knowledge of EHR

Education and Experience

• High School Diploma or equivalent
• 5+ years of experience obtaining authorizations

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.