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
- 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 and Knowledge
- Intermediate computer skills including MS Office
- Understands authorization process and procedures
- Demonstrates knowledge of EHR
- Attention to detail
- Collaboration skills
- Communicates proficiency
Education and Experience
- High School Diploma or equivalent
- 5+ years of experience obtaining authorizations