1 CMA (Prior Authorization)- Greenville Job in Greenville, NC

SORT BY

SET JOB ALERT

OFF

Details...

CMA (Prior Authorization)- Greenville

Eastern Nephrology Associates, PLLC

Greenville, NC | Full Time

$36k-43k (estimate)

3 Months Ago

CMA (Prior Authorization)- Greenville

$36k-43k (estimate)

Full Time 3 Months Ago

Save

Eastern Nephrology Associates, PLLC is Hiring a CMA (Prior Authorization)- Greenville Near Greenville, NC

Prior Authorization Specialist

Title: Prior Authorization Specialist	FLSA Status: Non-Exempt	Shift: M-F, 8-5
Reports to: Unknown	Department: Unknown	Employment Status: Full-Time
Supervisory Responsibilities: None	Location: Greenville/Remote	Date Created/Last Evaluated: 05/15/2024
Summary The position is responsible for obtaining and tracking of prior authorizations for medications, infusions, procedures, and office visits from various insurance companies. Form completion for authorizations and patient assistance.
Qualification RequirementsTo perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Minimum Qualifications High School or equivalent Previous work experience in a clinic setting. Previous work experience in prior authorizations, minimum two years preferred. Knowledge of VA and Tricare authorizations Minimum of 1 to 2 years of clinical experience
Knowledge, Skills, and Abilities Verifies insurance eligibility for all current patients receiving procedures, injections, or infusions in a timely manner. Communicates payer authorization and eligibility to designated staff. Enters insurance and eligibility information into the electronic health system. Notifies designated staff member for all non-covered procedures. Performs re-authorizations as needed prior to expiration date. Communicates and documents changes in authorization status and notifies appropriate staff. Monitors and ensures that all authorizations are current and active. Reviews and ensures appropriate processing of authorizations. Sends additional correspondence to payers as requested. Maintains professional and positive communication with payers, clients, and other staff. Maintains confidentiality of all information regarding clients, families, and employees Consults with management, clinical, and billing employees. Knowledge of Medical Terminology, CPT codes and ICD-10 codes Maintains knowledge regarding new procedures, medications, and health information systems. Knowledge of third-party payer’s regulations (Medicare, Medicaid, VA, Tricare, and commercial insurance) Self-directed and motivated Work independently with minimal oversight. Ability to prioritize tasks. Understanding of CPT codes and ICD-10 codes Strong organizational skills Excellent communications skills verbally and non-verbal Basic computer skills such as Outlook, Word, and Excel Patient assistance form completion for those that need assistance with medications
Essential Functions (%) 5% lifting 20% form completion 20% phone 50% computer work 5% Other tasks as required
Physical Demands Hearing, visual acuity, depth perception, balancing, handling, and talking.. Reaching, grabbing, holding – fine motor skills. Extended periods in a stationary or standing position. Repetitive motion such as entering data into computer-based programs and frequent phone use. Lift or move up to 25 pounds. Employee is expected to use appropriate ergonomics and tolls such as hand carts for heavier loads.
Work EnvironmentWork is normally performed in a typical interior/office work environment. The noise level is usually moderate. While performing the duties of this job, the employee is regularly required to stand and talk or hear.

The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required of the position. All employees may have other duties assigned at any time.

Benefits: 401(k) includes Safe Harbor and Profit Sharing / Choice of Medical Insurance Plans / Dental / Paid Disability and Life Insurance / Optional Life, Accident and Critical Insurance / Generous Paid-Time-Off

Eastern Nephrology is the region’s largest, private medical practice specializing in diseases and disorders of the kidney. Our continued growth is a direct result of providing excellent service and care to our patients. ENA is always seeking talented and compassionate clinical and administrative people to join our practice family.

Eastern Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition, or any protected category prohibited by local, state or federal laws. We are an E-Verify Employer. Pre-employment background checks are required for all employment positions. If you are a qualified individual with a disability and are unable or limited in your ability to use or access the online application system process due to your disability, please contact the Human Resources Department at 252-864-2049 to request assistance. The company provides reasonable accommodations to qualified individuals with a disability to enable them to effectively participate in the application process, as required by law.