Assist in areas of authorization process such as triage, paper flow and research.
- Verifies eligibility and benefits for each referral
- Inputs all referrals into computer and generates hard copy
- Provides referral and authorization to external providers
- Communicates authorization status to patients
- Organizes and maintains filing system of authorization/referral hard copies
- Provides information required for denial letters to clerical staff for patients whose benefits do not cover requested services
- Inputs ICD9 codes and CPT codes in computer for referral
- Prepares assigned correspondence and reports and compiles statistical data as directed
- Tracks all types of references on computer system on hard copy log and compiles statistics monthly
- Maintains good attendance
- Represents department / group and organization in a professional and positive manner
- Supports and facilitates teamwork within the department / group and the organization
- Participates in scheduled departmental / group meetings
- Other duties as assigned
High school graduate or G.E.D.
Medical Terminology Certificate
6 months experience in the medical field, either in a hospital, clinical or insurance setting that includes experience with computers
Demonstrates excellence and high quality in performing responsibilities
Ability to handle occasional pressure due to multiple calls or interruptions.
Other: Normal office environment. May be subject to temperature variations in the office.
Occasional early morning, evening or weekend work.
NAMM North America Medical Management - 7 months ago