Description

Texas Diabetes & Endocrinology, P.A. (TD&E) has grown over the years to meet the Endocrinology needs of the Austin community. Our mission is to strive to provide expert care in Diabetes, Thyroid problems, Osteoporosis, Weight management and hormonal conditions by providing thorough evaluations and innovative, personalized solutions focused on our patients’ success. Our employees are the strength that keeps us moving forward.

Our Clinical Department is looking to hire a regular full time Medical Assistant-Prior Authorization for our Round Rock location!

Medical Assistant-Triage Support Essential Functions:

The Triage Support Medical Assistant follows Triage procedures and protocols and assists with calls and walk-in patient needs. The Triage Support Medical Assistant may take lead on or assist with one or more of the following areas:

Prescription Prior Authorizations

• Answers the PA line; returns voicemails.
• Receives and processes PA requests from pharmacies and patients.
• Communicates with insurance companies and fills out PA forms including patient diagnosis, lab results, and justification for requested medication; works with provider to complete authorization. 
• Administers the plan exclusions process, seeking new prescription from provider as needed.
• Communicates approvals and denials. Assists provider with the appeals process, including Letter of Medical Necessity.
• Stays up to date on insurance-approved medications and formulary changes.
• Provides samples and coupons to patients as authorized.
• Uploads PAs and logs all interactions in the EMR.

Labs Processing

• Processes all labs received electronically or via fax. Links labs to the patient file in EMR. Enters lab results into flow sheet.
• Communicates errors and urgent abnormal lab results to the Triage Nurse/Triage MA.
• Provides remaining labs for appointments more than 30 days from the date to provider for mailing. Places labs for patients with return visits (RVs) within 30 days in the provider box noting their RV and last visit.

CGMS initiations/Insulin Pump Process

• Orders pumps and CGMS for assigned location(s); completes PAs and coordinates delivery as needed.
• Completes CGMS initiations including insertion, patient training, removal, results downloads for provider, and cleaning/maintenance of devices.
• Teaches patients glucose meter use.
• Orders labs for patients as required by practitioner.
• Administers the pump denials process which includes Letters of Necessity.

Pump Specialist

• Downloads all patient pumps/CGMS in preparation for incoming appointments, prepares provider chart notes
• Answers live calls on nurses line and routes message to appropriate Triage Nurse/Triage MA; returns voice messages from pumps line
• Gathers and prepares provider chart note daily
• Prepares lab and imaging reports daily for upcoming patients

Drug Sample/Drug Rep Management

• Acts as the location point of contact for all drug reps.
• Informs drug reps of drug sample needs and coordinates delivery.
• Maintains the drug medication sample closet and drug medication inventory.

Clerical

• Prepares labs and imaging reports daily for upcoming patients
• Completes bi-monthly inventory of medical supplies including but not limited to gloves, gauze and biopsies materials and reports inventory to Clinical Manager at location.

Faxes/Mail

• Collects and routes electronic and paper faxes to appropriate department folder or employee.
• Routes provider mail noting last visit information.
• Scans documents into the patient file.

Additional Essential Functions:

• Administers testosterone, -12 and Prolia injections

Additional Non-Essential Functions:

• May assist Rx Specialist with processing prescription requests
• May assist with Floor MA duties during staffing shortages
• Assists with calls on the emergency/MD line.
• May occasionally assist with moving or lifting patients up to 50 pounds.
• Assist with other duties as assigned

Qualifications

Preferred:

• 2 years of prior Medical Assistant experience; Graduated from an accredited Medical Assistant Program; Certified or Registered Medical Assistant credentials, prior triage experience.
• Bilingual in Spanish

AAP/EEO Statement

Texas Diabetes & Endocrinology, P.A. (TDE) provides equal employment opportunities (EEO) to all employees and applicants for employment in accordance with applicable federal, state, and local laws. TDE complies with applicable state and local laws governing nondiscrimination in employment in every location in which it has facilities.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.