What are the responsibilities and job description for the Hybrid Prior Auth Specialist/Clinic Float position at Sullivan County Community Hospital?
QUALIFICATIONS
Education
- Graduate from an accredited Medical Assistant Program or an approved School of Nursing.
Experience/Skills
- Knowledge of practice operations
- Clinical experience
- Knowledge of medications
- Commitment to “cross training” assigned tasks
- Commitment to customer satisfaction in responding to all patient/customer inquiries (internal customers)
- Ability to use office equipment
- Ability to adapt to changes in procedures and/or workload
- Excellent written and oral communications skills
- Ability to work independently with little supervision
- Ability to work under pressure with time constraints
- Ability to concentrate
Required Licenses/Certifications
- Medical Assistant certification or Nursing Licensure in the State of Indiana
- CPR
Working Conditions
- Clean, well-lit, well-ventilated general office working environment
- Hybrid position; utilizing in-clinic time and remote work time at the discretion of the RN Clinical Manager after 90 days of in-clinic probation.
- Must have private, dedicated work space to work in remote environment.
ROUTINE RESPONSIBILITIES
Behavioral Standards
- Consistently complies with established Behavioral Expectations
Patient Representative Duties
- Responsible for prior authorizations for medications.
- Responsible for accurate and timely processing of prior authorizations, perform appeals as necessary, and the ultimate resolution of each case as assigned.
- Back up to hospital medication prior authorizations if needed.
Service
- Responds promptly to patient needs
- Facilitates professional/empathetic resolutions for patients
- Answers prior authorization questions for patients
Clinical Staff
- Works with Clinical Supervisor to provide requested information needed for projects
- Will fill in as float or phone nurse in clinical schedule when deemed necessary by management
- Maintains/meets all Clinical skills/duties required by SCCH Clinics as an employee
- Performs other duties as assigned
Full time/Day shift
64 hours/Biweekly