Medical Authorization Specialist - Patient Access & Pre-Auth Expert

PACM, Inc.; West Haven (CT); Presencial; USD 25.000 - 39.000; Jornada completa

Descripción de la vacante

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.

Formación

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

Responsabilidades

• 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

Conocimientos

Authorization process

EHR knowledge

Educación

High School Diploma or equivalent

5+ years of experience obtaining authorizations

Descripción del empleo

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.