Job Description
Job Description
Job Description
Duties and Responsibilities
Primary Job Functions:
- Responsible for reviewing, submitting, monitoring, and responding to issues regarding medication prior authorizations.
- Reviews patient medical history to identify supporting documentation in the patient chart relevant to the medication.
- Professionally communicates with prescribers, practice support staff, patients, and representatives of insurance companies; includes oral and written communication.
- Responsible for contacting insurance companies via appropriate method to obtain prior authorization.
- Updates information in the patient medical record with approval or declination information; follows up with ordering physician as to status of prior authorization.
- Efficiently tracks pending authorizations for multiple offices/prescribers.
- Creates a positive, professional, service-oriented work environment for staff, patients, and family members by supporting the mission and values of OGG.
Secondary Job Functions:
- Attends required meetings and training as requested.
- Maintain confidentiality of patient and financial information by utilizing HIPPA guidelines and regulations.
- Adheres to all Federal, State, and Local laws and regulations as well as policies set forth by Ohio Gastroenterology Group Inc, and its related parties.
Knowledge, Skills, and Abilities
- Knowledge of third-party payers and prior authorization requirements
- Understanding of basic medical terminology and medications
- Proficient use of office equipment, such as copier, fax machine, phones, etc.
- Intermediate computer skills including use of Microsoft Office (Excel and Word), electronic mail, payer websites, physician practice management, and electronic medical record systems.
- Strong time management skills
- Ability to work independently with minimal supervision and to manage multiple priorities.
- Strong written and verbal communication skills
- Ability to effectively communicate with a variety of individuals.
- Neat appearance, professional demeanor, and pleasant voice
Credentials and Experience
- Must have a high school diploma or equivalent.
- One (1) year of experience and relevant knowledge of insurance eligibility or prior authorization in a healthcare setting preferred.
- Certified pharmacy technician, certified medical assistant, or licensed practical nurse preferred.
Work Environment
- Minimal medical office exposure that may require contact with adult patients
- Office workstation environment with numerous employees
Ohio Gastroenterology Group offers a nice life/work balance and a great benefits package that includes:
- Medical, dental and vision coverage- benefits are effective the first of the month following 30 days of employment
- Company paid life insurance and short term disability
- Generous paid time off plans (vacation, sick and personal)
- 401(k) plan that offers a 3% safe harbor contribution with immediate vesting as well as annual profit sharing contributions.
- Cash balance pension plan – company contributes 2.5% and offers full vesting after 3 years of employment.
- Tuition reimbursement programs
- Employee appreciation programs
- Uniform reimbursement programs
- Learning and development training
Job Tags
Holiday work, Temporary work, Local area, Immediate start,