Job Description
Job Description
Job Description
emp Assignment About 6 weeks
We are seeking a Prior Authorization Specialist for a temporary role in San Juan Capistrano. This position involves a combination of secretarial tasks and medical administration duties, including working with insurance and prior authorizations.
Key Responsibilities:
- Schedule Appointments : Coordinate patient visits.
- Insurance Verification : Confirm insurance before appointments.
- Patient Information : Input patient demographics and details.
- Collect Payments : Process co-pays and outstanding balances.
- Obtain Authorizations : Secure authorizations for visits (HMO, Workers' Comp).
- Prior Authorization : Execute the principles of prior authorization to ensure patients receive appropriate care at the right time and in the right setting.
- Problem Solving : Address complex prior authorization questions and issues.
- Eligibility & Benefits Check : Verify coverage for services like DME (Durable Medical Equipment) and home health before passing on requests for approval.
- Compliance : Ensure all authorizations meet required turnaround times and maintain compliance in all steps of the prior authorization process.
- Resource Management : Use supplies and equipment responsibly.
- HIPAA Compliance : Protect patient confidentiality at all times.
- Administrative Tasks :
- Answer phone calls.
- Sort and distribute mail and faxes.
- Manage medical records.
- Referrals :
- Coordinate patient referrals to specialists or diagnostic services.
- Obtain authorizations for referrals.
- Communicate with patients, providers, and insurance companies regarding the status of referrals.
- Maintain accurate referral records in compliance with HIPAA.
Required Skills & Qualifications:
- Medical Office Experience : Prior experience in scheduling, phone operations, and working in a medical setting.
- Communication : Strong written and verbal communication skills.
- Technical Skills : Intermediate proficiency in math and computer skills. Familiarity with medical software.
- Multitasking : Ability to prioritize and manage multiple tasks in a fast-paced, high-stress environment.
- Interpersonal Skills : Friendly, outgoing, and able to interact professionally with staff and patients at all levels.
- Confidentiality : Knowledge of HIPAA regulations and ability to maintain patient privacy.
This position requires someone who can handle changing priorities and solve complex prior authorization issues while maintaining a positive and professional attitude.
If you are organized, detail-oriented, and enjoy working in a healthcare setting, apply today!
Job Tags
Temporary work,