Medical Authorization & Scheduling Specialist

Pulmonary Medicine, Infectious Disease & Critical Care Consultants Medical Group, Inc.; Roseville (CA); On-site; USD 30,000 - 39,000; Full time

Job summary

Pulmonary Medicine Associates in Roseville, CA is seeking an Authorization Specialist to manage insurance authorizations, referrals, and scheduling for our busy pulmonary care practice. You will verify benefits, submit requests, and coordinate with hospitals and clinics to ensure timely approvals.

The role requires a high school diploma, familiarity with HMO/PPO plans, strong phone etiquette, and the ability to work independently while handling multiple tasks.

Qualifications

• High school diploma or GED.
• Knowledge of medical terminology.
• Knowledge of medical billing procedures and HMO/PPO insurance programs.
• Excellent phone etiquette and verbal communication skills.
• Strong customer service skills and ability to establish and maintain relationships with patients and staff.
• Strong attention to detail.
• Ability to maintain confidentiality of sensitive information.
• Ability to work independently and juggle multiple priorities.
• Ability to communicate clearly and effectively with patients, families, physicians, staff, and other customers.
• Must be able to accurately type 45 WPM.
• Valid California driver’s license and automobile insurance; ability to drive to different clinics.

Responsibilities

• Schedule pulmonary procedures, diagnostic testing, and follow-up appointments according to physician orders and protocols.
• Obtain and track insurance authorizations and referrals for procedures and services.
• Verify insurance benefits, eligibility, and authorization requirements.
• Submit authorization requests to insurance companies and follow up for timely approval.
• Monitor authorization status and maintain EMR documentation.
• Coordinate procedures with hospitals, surgical centers, imaging facilities and labs.
• Communicate with patients regarding dates, instructions, referrals, and requirements.
• Ensure clinical documentation and records are available prior to procedures.
• Identify and escalate authorization or scheduling issues delaying care.
• Reschedule procedures when needed and inform all parties.
• Work with providers, nurses, medical assistants, referral coordinators, and front-office staff to facilitate care.
• Maintain scheduling and authorization records while protecting confidentiality.
• Follow payer requirements and healthcare regulations.
• Perform other front office tasks as assigned.

Skills

Medical terminology

Phone etiquette

Customer service

Communication skills

Confidentiality

Multitasking

Typing speed 45 WPM

Independent worker

Education

High school diploma or GED

Job description

Pulmonary Medicine Associates in Roseville, CA is seeking an Authorization Specialist to manage insurance authorizations, referrals, and scheduling for our busy pulmonary care practice. You will verify benefits, submit requests, and coordinate with hospitals and clinics to ensure timely approvals.

The role requires a high school diploma, familiarity with HMO/PPO plans, strong phone etiquette, and the ability to work independently while handling multiple tasks.