Authorization Clerk - Tri City Urology - Waring Road - Day - Full Time

Hours:

Shift Start Time:

8 AM

Shift End Time:

4:30 PM

AWS Hours Requirement:

8/40 - 8 Hour Shift

Additional Shift Information:

Weekend Requirements:

No Weekends

On-Call Required:

No

Hourly Pay Range (Minimum - Midpoint - Maximum):

$25.000 - $26.320 - $31.160

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.  The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do

The Authorization Clerk maintains the highest standards of customer service excellence. Responsible for a variety of duties including: registration, scheduling, exam order entry, record integrity, obtaining insurance authorization and referrals.

Required Qualifications

• H.S. Diploma or Equivalent
• 3 Years Authorization Clerk experience in a hospital or medical office.

Essential Functions

• The position characteristics reflect the most important duties, responsibilities and competencies considered necessary to perform the essential functions of the job in a fully competent manner. They should not be considered as a detailed description of all the work requirements of the position. The characteristics of the position and standards of performance may be changed by TCMC with or without prior notice based on the needs of the organization.

Maintains a safe, clean working environment, including unit based safety and infection control requirements.

Responsible for verifying insurance coverage, eligibility, benefits, obtaining authorizations and pre-certs as required by the individual insurance company.

Obtains prior authorization for medication not on patients insurance formulary as requested by MD or MA, completes prior authorization transaction and notifies requesting MD or MA of any issues.

Processes all information required to complete referrals prioritizing by level of urgency and patient need.

Accurately enter notes regarding letters or correspondence from insurance companies regarding insurance authorization or other notifications.

Adheres to all medical practice policies and procedures.

Inform patients of referral status.

Answers telephone inquiries on status of referral.

Performs other duties as necessary.

Knowledge, Skills, and Abilities

• Ability to effectively present information in one-on-one and small group situations to patients, clients, and other employees of the organization.
• Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
• Must be able to interact and communicate with all levels of staff, physicians, patients and families in an effective manner.
• Demonstrated knowledge of computer technology, including word processing, spreadsheet, and database.
• Ability to work under stress and deal effectively and courteously with difficult people.
• Ability to relate and work with people of all authority levels, ages, social and ethnic backgrounds.
• Knowledge of medical procedure, as they apply to insurance authorizations.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class