Under general direction, provides indirect patient care to patients. Responsibilities include, obtaining prior-authorizations, following up and communicating with patients as to the status of their prior-authorization, and working with insurance companies.

Essential Duties and Responsibilities:

• Performs job in accordance with Company Mission, vision, and goals
• Exercises confidentiality in all areas; abiding by HIPAA rules and regulations
• Accurately completes applicable documentation as required for the completion of prior-authorizations
• Prepares all forms and requisitions as need by insurance companies
• Follows through to ensure that all prior-authorizations are submitted in a timely manner and followed up on within 72 business hours
• Obtains prior-authorization for prescriptions
• Monitors and maintains the task buckets associated with prior-authorizations
• Ensures accuracy of all forms submitted to the insurance companies
• Provides professional and courteous customer/patient care; displaying knowledge and enthusiasm for the treatment approach
• Expedites service in situations requiring urgent attention
• Maintains high-level of product and service knowledge
• Identifies opportunities for process improvement and contributes to solutions to enhance workflow efficiency and the customer’s/patient’s experience
• Communicates medication denials, as well as next steps, to appropriate staff
• Participate in and complete all required trainings and in-services.
• Other duties as assigned.

Minimum Qualifications:

• High School Diploma or equivalent.
• At least two (2) years of related experience working as a Medical Assistant or Nursing Assistant.
• Must have knowledge of Internet and Microsoft Office software (MS Word, MS Excel, MS PowerPoint, MS Outlook).
• Must have excellent written and oral communication skills.
• Must be able to work individually as well as within a team.
• Must be able to multi-task and prioritize.
• Must demonstrate extreme attention to detail.
• Must possess strong organization skills.
• Must be able to perform calculations, problem solve and use reasoning.
• Must have knowledge of medical practices and medical terminology.
• Must be able to meet predefined production and quality standards.
• Must be able to effectively manage and direct others.
• All staff are expected to have a strong desire to provide excellent customer service; to comply with the rules and regulations of those organizations to which we are accountable; to have high ethical and professional standards of conduct; and to have an attitude of wanting to continuously improve their own professional performance.

Preferred Qualifications:

• Associates Degree from an accredited college.
• One (1) year of clinical expertise in the pain management field.
• One (1) year of prior experience working with an Electronic Medical Record (EMR).

Driving/Travel:

The employee must have reliable transportation. While the primary workplace may be closest to the employee’s home, work assignments could be in any of the Company’s locations.