CMA/Prior Authorization Specialist- Digestive Health- St Mary`s
Job Description and Essential Functions
Job Title/Position: CMA/Prior Authorization Specialist
Job Classification: Administrative/Professional Support/Direct Patient Care/Hands-On Patient Care
Date of Analysis: Date of Revision/Review:
Prevea offers a competitive benefit package that includes Health, Dental, Disability, Life Insurance, H.S.A, 401k with match and PTO. Benefit summary sheets are available upon request or shown at www.prevea.com
Brief Description of Job Responsibilities:
Providing exceptional care for our patients as well as recognizing the value of your co-workers is the expectation of all members of the Prevea Health organization. All members are expected to focus on the patient`s needs; relate to all in a friendly, accepting manner; communicate in a positive and professional way to patients and co workers; use time effectively and efficiently; and demonstrate an overall high level of performance.
(This list may not include all of the duties assigned)
- Works closely with department physicians and staff, coding and billing staff, to ensure understanding of information needed to obtain proper authorization for payment.
- Communicates with patients prior to specialty consultation or surgical procedure to provide them with information regarding their coverage.
- Identifies what is required for Preauthorization of surgical procedures and completes the process to minimize denial of claims.
- Preauthorization documentation.
- Communicate with hospitals and patient on progress/approval of Preauthorization.
- Room patients, obtain brief patient history, complaint, and document pertinent information
- Perform vital signs and other department specific screenings as applicable
- Facilitate/perform lab and diagnostic testing per provider order
- Assist with office procedures as directed (may include but not limited to: injections, phlebotomy, etc.)
- Provide telephone advice to patients as directed
- Call in prescription refills as directed
- Complete referral forms, and make referral appointments
- Act as a liaison for physicians
- Use of electronic medical record (EMR) (may include but not limited to: documentation, referrals, scheduling, order entry, pre-certification, etc)Performance Requirements:
- Proficiency in the use of computer, phone, and office equipment.
- Excellent organizational skills.
- Excellent communication skills and follow through with internal and external customers.
- Ability to work in a fast paced environment
- Must display excellent teamwork
- Ability to work under stressful or emergency situations with high concentration and energy level
- Must possess logical thinking skills to effectively solve problems
Non-Essential Duties: Other duties as assigned within scope of practice.
- Current Certified or Registered medical assistant
- Current CPR certification
- One year of experience in a medical or insurance role preferred.
- Knowledge of insurance and medical terminology.
- Knowledge of CPT/ICD-10 coding is useful.
- If hold other licenses that supersede CMA/RMA license may practice to the highest level of licensure with the approval of Quality Resources in writing. Approval to be kept on file with department supervisor. Employee must maintain licensure to continue working at higher level of service.
Typical Physical Demands:
Combination of medical office and exam/procedure room settings. Possible exposure to communicable diseases, toxic substances, medicinal preparations and other conditions common to a clinic environment. Work may be stressful at times.
Typical Working Conditions:
- Requires full range of body motion including handling and lifting patients, manual and finger dexterity and eye-hand coordination. Involves standing and walking.
- Occasionally lifts and carries items weighing up to 50 pounds as needed for patient transfer (with assistance or other staff). Sometimes has to wheelchair patients with a force of up to 70lbs. Must be able to lift up to 30 pounds of supplies.
- Requires visual acuity correctable to 20/30, normal color perception and hearing within normal range.
- Requires exposure to bodily fluids.
In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United State and to complete the required employment eligibility document form upon hire. Prevea participates in E-verify. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify
Essential Functions/Physical Demands
Job Title/Position: Certified Medical Assistant/Prior Authorization Specialist
Job Classification: Direct Patient Care/Hands-On Patient Care/Administrative/Professional Support
How to Apply:
We have over 1200 reasons for you to consider a career with Prevea Health--they're our employees. We're an organization that values teamwork and provides continuous education, training and support so every member of the team contributes to our success. We offer a competitive salary and benefits package in an environment geared to professional and personal growth. No matter what your background or professional interests are, we think you'll like what we have to offer. Together we are the best place to get care and the best place to give care.
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Prevea Health is an Equal Employment Opportunity/Affirmative Action employer.