Pre-Authorization Coordinator

Job Description

Community Health Centers is looking for a part-time Pre-Authorization Coordinator to join our team!

This staff member supports the mission of Community Health Centers by assuming responsibility for facilitation of all aspects of pre-authorization process for medications prescribed by primary care and psychiatric providers.

BASIC QUALIFICATIONS:

Education & Experience:

High School Diploma or GED.

Minimum of one year experience in healthcare/medical office setting required

Prior experience with pre-authorization is strongly preferred

Knowledge, Skills & Abilities:

Ability to understand and follow strict confidentiality policies and procedures.

Ability to convey detailed information, ensuring others understand

Ability to give full attention to what others are saying, understand the points being made and asking appropriate clarifying questions.

Ability to work and problem solve on an individual level as well as part of a team.

Strong organization, prioritization and time management skills

Ability to operate standard office equipment including fax machines, copiers and computers

Ability to electronically file information and retrieve electronic files quickly and accurately

Ability to work on site in an office setting

Licensure, Certification or Other Requirements:

None

The information below is intended to describe the general nature and level of work required for this position. The information is not to be construed as an exhaustive list of all responsibilities and/or duties

required. Community Health Centers (CHC) reserves the right to add, remove or revise job duties and responsibilities as demanded by business needs.

ESSENTIAL DUTIES:

Request, track and obtain pre-authorization from insurance carriers within allotted timeframe

Follow up on denied pre-authorizations in collaboration with the in-house clinical pharmacist and other clinicians

Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations Communicate any insurance changes or trends with practice management and clinical teams

Clearly document all communications and contacts with providers, patients, and personnel in standardized documentation requirements, including proper format.

Locate, retrieve, prepare and deliver patient information in electronic, faxed or paper form.

On site collaboration with providers and Clinical Pharmacist to ensure timely processing

Review pre-authorizations for completeness, accuracy and compliance with regulations

Protect the security and confidentiality of patient records and related patient health information according to CHC policies and procedures.

Monitor the Electronic Practice Management (EPM) and Electronic Medical Record EMR tasking as necessary

Classify, store, analyze and destroy patient health information records per CHC regulations.

Train practice management and clinical staff to assist with pre-authorizations as needed

Maintain and track performance metrics as established by the supervisor and communicate when response time is not consistent with goals set by medical leadership

On site management of paper faxes, urgent PA requests and team support

Other duties as assigned

NON-ESSENTIAL DUTIES:

Other duties as assigned

PHYSICAL DEMANDS AND WORKING CONDITIONS:

Ability to lift up to 35 lbs.

Work performed in an indoor, environmentally controlled office setting

Ability to view and read printed documents and on-screen information

Onsite/in person position

CHCB employees enjoy comprehensive benefits including:

Medical insurance with $600 annual wellness perks

Monthly stipend for those with alternate health insurance

Flexible Spending Account and Dependent Care Account

Excellent Dental and Vision coverage

Life insurance, AD&D, Short Term/Long Term Disability, Accident Insurance, and Critical Illness Insurance

401K via Vanguard, as well as fiduciary services via Morgan Stanley (Employer contribution of 3% of your annual salary after 1 year of service regardless of personal contributions)

Continuing Education funds for licensed applicable roles; pooled departmental funds as allowed for other roles

Generous Accrued CTO in addition to 8 paid annual Holidays (6 fixed, 2 floating)

Employee Assistance Program available to all household members

Local discounts and perks at fitness, restaurants, and local businesses!

Part-time