Medical Assistant/ Prior Authorization Clerk

Job Summary

We are seeking a dedicated and detail-oriented Medical Assistant/Prior Authorization Clerk to join our healthcare team. In this dynamic role, you will be responsible for managing patient interactions, assisting with clinical procedures, and handling prior authorization processes for various medical services. Your expertise will ensure smooth clinic operations, compliance with healthcare regulations, and timely approval of insurance authorizations. This position offers an exciting opportunity to contribute to patient care while streamlining administrative workflows in a fast-paced medical environment.

Responsibilities

• Assist healthcare providers with clinical tasks such as taking vital signs, preparing patients for examinations, and documenting medical histories using Electronic Medical Records (EMR) or Electronic Health Records (EHR) systems.
• Verify patient insurance coverage and eligibility by conducting insurance verification procedures, ensuring accurate billing and reimbursement processes.
• Prepare and submit prior authorization requests for diagnostic tests, procedures, or treatments by collaborating with insurance companies and healthcare providers.
• Maintain strict adherence to HIPAA regulations and clinical confidentiality policies to protect patient privacy at all times.
• Utilize medical coding systems including CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding to accurately document diagnoses and procedures.
• Manage medical records efficiently, ensuring all documentation complies with health insurance policies and legal standards.
• Provide exceptional customer service by answering patient inquiries related to insurance policies, appointment scheduling, and medical records management.

Qualifications

• Proven experience working in a medical office setting with familiarity in clinical procedures and administrative duties.
• Strong knowledge of HIPAA regulations, medical terminology, and medical records management.
• Proficiency in EMR/EHR systems and electronic health records management tools.
• Experience with medical coding including CPT, ICD-9, ICD-10, and ICD coding practices.
• Understanding of health insurance policies, managed care processes, insurance verification procedures, and health insurance policy knowledge.
• Excellent organizational skills with the ability to handle multiple tasks efficiently in a fast-paced environment.
• Prior experience with insurance authorization processes is highly preferred.

Benefits:

• 401(k)

Work Location: In person