Medical Authorization Specialist -Gastroenterology

Job Description

Job Description

Pay Range : $23.00 - $28.00 an hour.

By adhering to Connecticut State Law, pay ranges are posted. The pay rate will vary based on various factors including but not limited to experience, skills, knowledge of position and comparison to others who are already in this role within the company.

COVID-19 and Flu Vaccine Considerations
Masks are optional for employees, visitors, patients, vendors, etc. All employees are strongly encouraged and recommended to obtain the COVID-19 vaccination routinely.  Proof of annual flu vaccination is required for all employees.

PACT MSO is a Management Service Organization that supports numerous physician groups. We offer health benefits, paid time off, and a friendly working environment. We are a medium sized company with a family atmosphere.

PACT MSO has a busy Gastroenterology office that is seeking a Medical Authorization Specialist. Medical Authorization Specialist work Monday through Friday and the position will be in Hamden.  The hours range between 8:00am to 4:30pm for 8 hour shifts.

The position obtains and assures that all pre-authorizations are completed effectively, accurately, and efficiently.

Essential Functions

• Obtain authorizations or referrals
• Contact insurance companies, labs, etc. get proper authorization
• Analyzes information required to complete pre-authorizations with insurance carriers and service area contacts.
• Accurate and pertinent clinical data and demographics is compiled and communicated to the patient’s insurance company in a timely and organized fashion.
• Communicate information appropriately, accurately, and timely
• Enters necessary authorizations into applicable database.
• Retrieves medical records and critical information from referring provider(s) prior to patient procedures; ensures that all necessary laboratory, imaging test results, and medical records are obtained if needed.
• Collaborates with other staff members to ensure appropriate insurance information is obtained.
• Inform patients of their referral/authorization responsibilities.
• Advocates for patients by helping them navigate through the system.
• Develops tools to assess patient referral processes with respect to efficiency and customer service.
• Patient demographic and additional identifying Enter patient information in EHR
• Obtain pre-op clearances from provider offices
• Cover front desk as needed
• Prepare estimates for patient procedures
• Schedule office visits

Skills and Knowledge

• Intermediate computer skills including MS Office
• Understands authorization process and procedures
• Demonstrates knowledge of EHR
• Attention to detail
• Collaboration skills
• Communicates proficiency

Education and Experience

• High School Diploma or equivalent
• 5+ years of experience obtaining authorizations