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.
• 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
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
• 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
Combination of walking, sitting, hearing, standing, bending, reaching, and lifting. Must be able to lift up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus. Occasional stress from balancing multiple tasks.
At Wellmont Health System, wellness is paramount. Wellmont Health System provides general and advanced medical-surgical care to residents of...