Openings >> Request Specialist-Medical Authorizations/Referrals
Request Specialist-Medical Authorizations/Referrals
Summary
Title:Request Specialist-Medical Authorizations/Referrals
ID:20154671891
Labor Type:Temporary
Posting #:F-RS
Location:Mission Hills, CA
Compensation:$18.00
Description
6 Month Contract
$18.00 Per Hour
 

Must Haves:

  • Excellent Customer Service/Phone etiquette
  • Need experience with referrals, prior authorization
  • Ideal candidates are medical assistant (preferred) or medical receptionist
  • Knowledge of CPT codes and diagnosis codes and medical terminology
  • Spanish speaking preferred but not required

Preferred Experience:

  • Previous experience as a Medical Assistant in a hospital, managed care, or medical clinic setting.
  • Bilingual – Spanish/English
Job Title: Request Specialist

Inputs retrospective authorizations into various systems.
Calls on-call physicians for emergency authorizations and inputs into the system real time.
Serves as liaison between patients, providers, and the organization regarding benefits and
eligibility.
Notifies patients and providers of routine authorizations or denials by mail and fax.
Notifies patients and providers of urgent or stat authorizations or denials by phone.
Interfaces with patients directly, and schedules appointments accordingly.
Handles phone calls from patients, hospitals and outside providers regarding inquiries on insurance benefits, authorizations, hospital bills and dates of service.
Inputs authorizations and tracks patients with HIV or on dialysis.
Assists case managers by gathering necessary information needed for review and assists with outbound calls to patients.
Completes required patient notification letters (e.g. extension, carve out, denial, approval letters).
Forwards any investigational or experimental requests to the patient’s health plan for review.
Attends required/assigned meetings by the supervisor and manager.


 
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