Clinical Operations Authorization Technician
Location: Honolulu, Hawaii
Description: AlohaCare is hiring Clinical Operations Authorization Technician right now, this vacancy will be dwelled in Hawaii. Further informations about this vacancy opportunity please read the description below. The primary function of this position is to facilitate the initial intake and processing of referrals, authorization, and notifications into Clinical Operations. Coordinates ! with clinical reviewers (nurse, pharmacist, or Medical Director) to ensure plan guidelines and required authorization turnaround times are met. Coordinates a varied workload and provides administrative support in the most efficient, accurate, and professional manner possible. Requires the use of judgment and initiative to determine approach or action for necessary for non-routine situations.
Primary Duties and Responsibilities:
Respond to requests by providers and members for the authorization of services.
Verify appropriate information is completed on request
Confirm member eligibility
Contact Provider’s office to gather additional member information (if applicable) to complete request, which may include medical notes and/or laboratory data needed by nurse reviewer
Authorize requested services and assign authorization numbers according to plan guidelines.
Refer authorizations requests to clinical staff when! needed for further review and decision making.
Prope! rly record and file all authorization requests.
Report potential high-risk members to Case Management.
Report potential disability members to the Disability Coordinator.
Ability to organize and prioritize workload.
Other duties as assigned.
Review coverage review / prior authorization request
Ensure coverage review turnaround times required by State and Federal agencies are adhered to by clinical professional decision-makers.
Required Competencies and Qualifications:
Course work or demonstrated knowledge of medical terminology
One to three years of medical office or related experience.
Working knowledge of Microsoft Office. (Work, Excel and some Access).
Strong oral, written and interpersonal communication skills, pleasant telephone etiquette.
Good organizational and analytical skills.
Flexibility and adaptability to changing priorities.
Positive a! ttitude and ability to accept directions.
Required Licensure/Certification:
High school diploma or equivalent.
Preferred Competencies and Qualifications:
Medical Assistant
Previous Authorization technician experience
Word processing skills of 45-60 wpm with high degree of accuracy and 10 key experience .
Course work or demonstrated knowledge of ICD-9 and CPT/HCPCS codes
An Equal Opportunity Employer
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If you were eligible to this vacancy, please give us your resume, with salary requirements and a resume to AlohaCare.
Interested on this vacancy, just click on the Apply button, you will be redirected to the official website
This vacancy will be started on: Wed, 24 Jul 2013 03:34:57 GMT
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