Authorization Specialist - USFTGP RCO

This position is responsible for obtaining pre-certifications and pre-authorizations for procedures and medications, scheduling appointments for outpatient testing with other providers, transcribes and triages patient calls to physicians, coordinates patient appointments/orders.

QUALIFICATIONS:
Required: High School diploma Medical Assistant or LPN training - Preferred Work Experience and Additional Information • 6 months medical office experience to include auth/pre-cert • Knowledge of medical terminology, CPT & ICD-9 coding • Excellent communication skills Duties & Responsibilities • Obtains relevant information to initiate & coordinate the authorization/pre-certification process between the referring physician, insurance carrier, and organization for timely scheduling • Develops working relationships and recommends procedures between the referring physician, the organization, the insurance carrier and other agencies for continuity of care • Assists and educates patients through the process to provide a positive patient experience • Maintain the patient's EMR by entering detailed notes related to the procedure, benefits, and authorization for a complete & accurate record • Responsible for compiling relevant information and documents for peer-to-peer reviews for peer-to-peer reviews for timely resolutions.