Medical Authorization Specialist: Patient Access & Referrals

PACM, Inc.; West Haven (CT); On-site; USD 40,000 - 60,000; Full time

Job summary

PACM, Inc. in West Haven, CT is seeking a Medical Authorization Associate to obtain and assure pre-authorizations are completed accurately and efficiently. The role is on-site, Monday–Friday, 8:30am–5pm, in West Haven.

Responsibilities include contacting insurers and labs, analyzing required information, entering authorizations into the database, and assisting patients through the referral process while maintaining meticulous records and patient privacy.

Qualifications

• Intermediate computer skills including MS Office.
• Understands authorization process and procedures.
• Demonstrates knowledge of EHR.
• Attention to detail.
• Collaboration skills.
• Communicates proficiency.

Responsibilities

• Obtain authorizations or referrals.
• Contact insurance companies, labs, etc. get proper authorization.
• 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

MS Office

EHR systems

Attention to detail

Collaboration skills

Communication skills

5+ years experience obtaining authoriz

Education

High School Diploma or equivalent

Tools

None

Job description

PACM, Inc. in West Haven, CT is seeking a Medical Authorization Associate to obtain and assure pre-authorizations are completed accurately and efficiently. The role is on-site, Monday–Friday, 8:30am–5pm, in West Haven.

Responsibilities include contacting insurers and labs, analyzing required information, entering authorizations into the database, and assisting patients through the referral process while maintaining meticulous records and patient privacy.