Authorization Tech
Location: Honolulu, Hawaii
Description: Staffing Solutions of Hawaii is currently interviewing Authorization Tech right now, this job will be dwelled in Hawaii. For complete informations about this job 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 review! ers (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 f! urther review and decision making.
- Properly record an! d 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.
- 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.
- High school diploma or equivalent.
- 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
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If you were eligible to this job, please! deliver us your resume, with salary requirements and a resume to Staffing Solutions of Hawaii.
Interested on this job, just click on the Apply button, you will be redirected to the official website
This job will be opened on: Fri, 15 Nov 2013 03:10:22 GMT