Medical Authorization Associate - Primary Care

PACT MSO has a busy Primary Care office that is seeking a Medical Authorization Associate. The position obtains and assures that all pre-authorizations are completed effectively, accurately, and efficiently. The hours are Monday-Friday, 8:30am-5pm in West Haven.

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