Hybrid Prior Auth Specialist/Clinic Float

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