Specialist, Authorization
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Job Location:
Wethersfield, CT - USA
Hourly Salary:
$ 16 - 23
Posted on:
8 days ago
Vacancies:
1 Vacancy
Job Summary
About Our Company
Were a physician-led patient-centric network committed to simplifying health care and bringing a more connected kind of care.
Our primary multispecialty and urgent care providers serve millions of patients in traditional practices patients homes and virtually through VillageMD and our operating companies Village Medical Village Medical at Home Summit Health CityMD and Starling Physicians.
When you join our team you become part of a compassionate community of people who work hard every day to make health care better for are innovating value-based care and leveraging integrated applications population insights and staffing expertise to ensure all patients have access to high-quality connected care services that provide better outcomes at a reduced total cost of care.
Please Note: We will only contact candidates regarding your applications from one of the following domains: @ @ @ @ @ @ or @.
Job Description
ON SITE - Wethersfield CT
Verifies insurance/managed care plans for eligibility for all of the insurance plans listed in the patient account and documents information in TxM and Athena.
Uses Athena to confirm eligibility and/or contacts the payer directly and documents the outcome in the patient account.
Obtain prior authorizations for each infusion plan listed on each day in a timely manner to as not to delay treatment for patients.
Will pre-certify all patient infusions and injections by confirming their insurance/managed care plan eligibility in addition to confirming whether prior authorization for visits and treatments are necessary.
Advises staff of any insurance plan updates.
Authorize specialty pharmacy drugs for patients and maintains an accounting through the PBM log system.
Required Qualifications:
High School graduate or equivalent
Prior medical office experience required
Prior Authorization Certified Specialist (PACS) preferred
Knowledge of insurance company/managed care organization constraints related to the retinal practices office procedures visits testing and drug therapy.
prior authorization experience of one year strongly preferred
Must have a high level of customer service interpersonal and organizational skills
Must be able to multi-task and handle a fast-paced busy environment
Strong working knowledge of basic computer programs and good typing skills
Ability to plan prioritize and complete delegated tasks in a reasonable span of time
Ability to work independently and as a member of a team
This position may require cross-coverage of other positions as needed and therefore a measure of flexibility to respond adequately to changing demands is required
This is a non-exempt position. The base compensation range for this role is $16.22- $23.00 per hour. At VillageMD compensation is based on several factors including but not limited to education work experience certifications location etc. The selected candidate will be eligible for a valuable company benefits plan including health insurance dental insurance life insurance and access to a 401k plan.
About Our Commitment
Total Rewards at VillageMD
Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMDs benefit platform includes Medical Dental Life Disability Vision FSA coverages and a 401k savings plan.
Equal Opportunity Employer
Our Companyprovides equal employment opportunities (EEO) to all employees and applicants for employment without regard to and does not discriminate on the basis of race color religion creed gender/sex sexual orientation gender identity and expression (including transgender status) national origin ancestry citizenship status age disability genetic information marital status pregnancy military status veteran status or any other characteristic protected by applicable federal state and local laws.
Safety Disclaimer
OurCompanycares about the safety of our employees and Companydoes not use chat rooms for job searches or Companywill never request personal information via informal chat platforms or unsecure Companywill never ask for money or an exchange of money banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at selectOur Companylocations during regular business hours only. For information on job scams visit file a complaint at Experience:
IC
Key Skills
- Sales Experience
- Crane
- Customer Service
- Communication skills
- Heavy Equipment Operation
- Microsoft Word
- Case Management
- OSHA
- Team Management
- Catheterization
- Microsoft Outlook Calendar
- EHS
About Company
Summit Health has more than 2,500 providers, 12,000 employees, and over 340 locations in New Jersey, New York, Connecticut, Pennsylvania, and Central Oregon. Determine your health needs and choose the provider that best fits your needs.
