Clinical Documentation and Authorization Specialist (Medical Assistant)

Document And Authorization SpecialistProvides coverage for duties relative to a centralized document and authorization system. Supports individual offices to ensure accuracy of information for incoming documents. Supports individual offices by updating medical records with pertinent information i.e.

lab results, historical information.Pay Range: $18.50 - 23.64/hourEmployment Type: Full Time, 72 hours every 2 weeks.Schedule: Mon, Tues, Wed, Fri 8am-5:30pm, no weekends or holidays.Requirements: High School Diploma/GED required, Current Medical Assistant Certification or Registration or LPN required, BLS for the Healthcare Provider 60 days after hire required.Communication Customer ServiceCommunicates professional and effectively with patients (or families when appropriate), internal customers, insurance payers, practice managers and multi-disciplinary team of providers.Understands essential role in patient care coordinationAnticipates and provides support to clinical teams so they can focus on medical office productivityAssures messages, forms, documentation are handled in a timely mannerCommunicates through a variety of methods including verbal, written, electronicAbility to prioritize messages, forms and documentsDocument ManagementTimely retrieval and delivery of fax inbox documentsAccurately assign patient documents to appropriate patient, folder, and naming convention guidelinesCompliant with patient confidentiality/HIPAA regulationsUpdates medical record with pertinent historical medical informationCompletes refill requests accurately for providers by reviewing current information, creating a telephone encounter and forwarding to provider.Prior AuthorizationReview and complete prior authorization requests for medications and high tech imagingUnderstand insurance coverage criteria and prior authorization requirements and stay up to date with changesProactively communicate with providers to gather supporting documentation for authorizationsTrack and monitor the status of all active prior authorizations and ensure timely submission of necessary documentationEducate patients on prior authorization process and address questions/concerns without the scope of license forwarding to provider or pharmacist as neededQuality ImprovementSupports the quality improvement activities of the practices and understands role in quality improvement initiatives.Participates in learning experiences as appropriate.Ensures compliance with Organizations Quality Improvement program.Maintains and closes work flow process relative to referrals, authorizations, and orders to satisfy quality improvement initiatives.Holland Hospital is an Equal Opportunity Employer, please see our EEO policy