Job Summary: Responsible for tasks/functions related to the prior authorization process and the Rx refill process. Assist in the delivery of health care by processing prior authorizations and providing the physicians with the information (per standing order) necessary to review, approve or deny refill requests
Essential Functions:
1. Responsible for initiation of all prior authorization requests.
2. Point of contact for patients with prior authorization questions.
3. Determine patient’s insurance and be familiar with the prior authorization requirements of each insurance company.
4. Maintain on-going tracking of prior authorizations and ensure prior authorizations are addressed in a timely manner.
5. Review medical documentation in EHR needed to complete prior authorization form. Ensure that CPT codes and ICD10 codes are correct. Identify and resolve any issues by clarifying with medical provider.
6. At a steady pace, accurately review, gather, and document pertinent medical information needed by the provider to process an electronic refill request, a telephone refill request, and/or a faxed refill request.
Required Knowledge, Skills, Abilities:
1. Graduate of a Medical Assistant program with a nationally recognized certification such as AAMA, NCCT, or AMT.
2. Knowledge of medical terminology.
3. Skill in establishing and maintaining effective working relationships with patients, medical staff, pharmacies, and insurance companies.
4. Proficient written and oral communication skills with patients, providers, insurance companies and referral department.
5. Ability to read, understand, and respond to detailed oral and written instructions. Ask clarifying questions as necessary.
6. Ability to communicate with providers and other departments as needed in order to resolve denied authorizations.
7. Using standing orders identify medical documentation in EHR needed by providers to safely approve or deny prescription refills.
8. Document criteria for specific medication categories in Rx Request message prior to routing to the provider.
9. Ability to be flexible and adaptable to changing assignments and work pace.
10. Ability to recognize problems and share ideas for solutions. Good judgment and decision-making skills.
11. Ability to utilize computer programs expected for patient care (eClinical Work), access patient information from the internet, and the ability to type at least 30 wpm.
12. Must be a team player, have a positive attitude, and be detail oriented.
13. Must be organized and able to manage competing priorities.
14. Able to work independently with minimal supervision.
15. Knowledge of common safety hazards and precautions to establish a safe work environment
Preferred Qualifications:
1. Current CPR certification.
2. Experience working in a medical office setting.
3. Experience working with Rx refills and/or prior authorization forms
Job Type: Full-time
Pay: $16 - $17 per hour
Benefits:
401(k)
Dental insurance
Disability insurance
Health insurance
Life insurance
Paid time off
Vision insurance
Medical specialties:
Pain Management
Schedule:
8-hour shift
Ability to commute/relocate:
Jacksonville, FL or Orange Park, FL: Reliably commute or planning to relocate before starting work (Required)
Experience:
EMR systems: 1-year eCW (Preferred)
License/Certification:
Certified Medical Assistant (Preferred)
Work Location: One location
Job Type: Full-time
Pay: $17.00 - $18.00 per hour
Work setting:
Ability to Relocate:
- Orange Park, FL 32073: Relocate before starting work (Required)
Work Location: In person