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Preauthorization Clinical Specialist LPN CMA RMA
$34k-42k (estimate)
Full Time 8 Months Ago
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Holston Medical Group, PC is Hiring a Preauthorization Clinical Specialist LPN CMA RMA Near Kingsport, TN

Our Mission
To provide quality medical care that exceeds patient expectations and builds lasting relationships.
Core Values
Life, Integrity, Compassion, Collaboration, Excellence, Accountability

General Summary:
The Preauthorization Clinical Specialist is responsible for obtaining authorizations for medications prescribed by our physicians in a call center environment. This position will obtain patient information to complete insurance requirements for obtaining pre-authorization for patients’ medications.

Main Responsibilities:
  • Interact with patients’, physicians and other staff within the offices to provide accurate, timely and responsive information
  • Obtains precertification/preauthorization from insurance companies, using an online application or by contacting insurer on the telephone.
  • Ensure efficient telephone communication
  • Maintain accurate records of what insurance require authorizations and types of medications that require an authorization.
  • Appropriate documentation of insurance approvals, denials and pending cases.
  • Maintain strict confidentiality in all matters relating to personnel and patient PHI (Protected Health Information)
  • Assist with other Call Center Activities as assigned.
Education/Experience/Knowledge:
  • RMA,CMA or LPN exp preferred but not required
  • General understanding of medical terminology
  • Familiarity with computers and other office equipment.
  • Must possess excellent communication and organizational skills
  • Ability to work in a team environment and collaborate with others


Physical/Mental Demands:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential: Communication with others to exchange or express information and ideas. Ability to receive detailed information through oral communication, and to make fine distinctions in sounds. Determine the accuracy, neatness, thoroughness of the work assigned and perceive general observations. Remaining upright on the feet, particularly 75% of the time. Moving about on foot to accomplish tasks. Bending body downward and forward by bending spine at the waist and/ or by bending leg and spine. Extending the hands and arms in any direction. Exerting force upon an object so that an object moves away/toward the force. Picking, pinching, typing or otherwise working, primarily with fingers. Applying pressure to an object with the fingers and palm. Perform a variety of duties, often changing from one task to another of a different nature. Perform with frequent interruptions and/ or distractions. Make appropriate job decisions following standard office policies and past precedents. Adjust priorities quickly as circumstances dictate. Ability to establish and maintain cooperative working relationships with co-workers and the public. Ability to interact appropriately with colleagues and patients for different purposes and different context.

Marginal: Must be able to remain in a stationary position at least 25% of the time. Medium work that includes moving objects up to 50 pounds occasionally. Perceiving attributes of objects, such as size, shape, temperature, or texture by touching with skin, particularly that of fingertips. Work independently and identify potentially more effective methods of work operations. Observing an area that can be seen up and down or to right or left while eyes are fixed on a given point. Ability to identify and distinguish colors.

Disclaimer:

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Management reserves the right to revise the job or to require that other or different tasks be performed as assigned.

All job requirements are subject to possible revision to reflect changes in the position requirements or to reasonably accommodate individuals with disabilities.

Education

Preferred
  • High School or better in General Studies

Licenses & Certifications

Preferred
  • Basic Life Saving
  • Cert Medical Assistant
  • Licensed Practical Nurse
  • Registered Medical Assist

Job Summary

JOB TYPE

Full Time

SALARY

$34k-42k (estimate)

POST DATE

09/23/2023

EXPIRATION DATE

05/09/2024

WEBSITE

ceoholstonmedicalgroup.com

HEADQUARTERS

Kingsport, TN

SIZE

<25

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