Medical Authorization Specialist Location:Virginia Beach, VA Job Type: Full-Time Shift: Mon day -Friday 8:15A M-5PM Job Duties of the Medical Authorization Specialist:
- Reviews and interprets medical record documentation for patient history, diagnosis, and previous treatment plans.
- Utilizes payer-specific approved criteria to determine medical necessity or the clinical appropriateness for the company's products.
- Submits pertinent demographic and supporting clinical documentation with pre-authorization requests timely to avoid unnecessary delays in patient treatment.
- Maintains and documents complete, timely, and accurate patient insurance and billing information.
- Performs on-going check and balance system to ensure the integrity of the patient billing data.
- Operates in a compliant manner by keeping patient data secure and confidential and adhering to all company policies and procedures.
- Works with the Order Management team to secure any additional information and medical documentation from the patient and/or prescribing HCP.
- Complies with all health, safety and environmental policies, procedures and job hazard analyses applicable to specified job activities including medical evaluations as required by job function.
- Completes all required training in a satisfactory and timely manner.
- Holds oneself and others accountable to conduct business in a manner compliant with Code of Compliance and Ethics, policies and procedures and internal controls applicable to their role.
What you' ll bring (Minimum Requirements) as a Medical Authorization Specialist :
- High School diploma or GED
- One (1) yea r previous experience of i nsurance verification or medical authorization experience involving medical record review.
These would be nice too (Knowledge Skills and Abilities )
- Attention to Detail: Able to perform tasks thoroughly and with care; checks work to ensure high degree of accuracy/completeness and early/on-time delivery
- Time Management: Able to prioritize multiple, competing priorities and manage time/workload. Demonstrated ability to effectively prioritize and juggle multiple time sensitive projects, multi-task, identify project interdependencies and potential risks/pitfalls.
- Communication Skills: Excellent verbal and written communication skills; ability to communicate and build relationships with all professionals at different levels within the organization.
- MS Office Proficiency: PowerPoint, Excel, Word, Outlook, Microsoft Suite
- Medical terminology and ICD-10 coding: Knowledge of and interpretation skills
The Lee Group is driven by our purpose and passion - Aligning talent, Growing Businesses and Changing Lives! And that's what the right job can mean for a family and what the right employees can mean for a business.We get up every day and come to work for 1 reason: Putting the right people, in the right seats. We are guided by our Core Values:
- We are purpose driven to change people's lives.
- We are approachable and genuine, with a great sense of fun.
- We are authentic straight shooters, unafraid of the truth.
- We get it, our business and our customers.
- We get it right!
Work with us and we will put over 50 years of experience to work for you!!The Lee Group is an equal-opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.All applicants must be willing to submit to pre-employment screenings including drug tests and criminal background checks.