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AUTHORIZATIONS CLERK

Company: Lags Spine and Sportcare Medical Centers Inc
Location: Bakersfield
Posted on: May 22, 2020

Job Description:

Description:
Lags Medical is seeking an experienced, talented and self-motivated insurance authorization clerk. Our Authorization Clerk maintains the highest standards of customer service excellence. Your duties will include:

  • Responsible for performing benefits verification and prior authorizations with insurance carriers to ensure optimal reimbursement for high cost medications, surgeries and procedures in a timely manner
  • To ensure correct referral form is completed for patient's plan. Reviews referral for accurate information prior to authorization to include patient provider identification information, clinic or procedure requested, and appropriate CPT-4 /billing codes.
  • Contacts clinic to obtain additional information as needed. Assists with medical necessity documentation and clearance to expedite approvals and ensure that appropriate follow-up is performed. Collaborates with other departments, clinics, and procedures areas to assist in obtaining authorization/pre-certifications in a cross functional manner.
  • Contacts plans to extend authorization dates, obtain additional visits and urgent/priority authorizations/pre-certifications, as needed.
  • Notifies clinic/procedure area, Nurse Navigator, Providers and/or patients to inform them of the authorization denials. Obtains additional clinical information for denials and submits appeals to the plan for further consideration.
  • Completes documentation of referrals in software to include the authorization number, number of visits, and the authorization period (dates) to ensure claims are paid in a timely manner.
  • Utilizes software to process and track referrals and submit medical records to insurance carriers to expedite prior authorization processes.
  • Creates patient's records and accounts and ensure that pre-authorization information is properly updated.
  • Secures patients demographics and medical information and ensures that all procedures are in sync with HIPPA compliance and regulation.
  • Other duties as assignedAt Lags Medical Centers, we turn great expectations into great accomplishments by having a clear philosophy. Our entire staff-across our vast territory of 40+ offices in five states-takes immense pride in honoring the beliefs that position us as a leader in musculoskeletal and pain medicine. Every day, we practice what we preach, bringing us closer to our patients, to our community, and to each other.We also understand that we are only as strong as our individual team members, and are always searching for talented and driven people. Come join a team of talented professionals. Apply today.We offer a comprehensive benefits package that includes medical, dental, vision, life insurance, PTO, 11 paid holidays and 401K. Working for Lags you will enjoy a work / life balance with a five day work week. .

    Requirements:
    Applicants for the Authorization Clerk should have a minimum of one year of Authorizations experience, as well as the following:--- High School Diploma or GED required--- Vocational/Tech or 2 year Associates Degree preferred--- Knowledge of insurance authorization required including Medicare, and Medi-Cal and commercial payer's requirements--- Medical terminology required and expertise must be demonstrated.--- Knowledge of Patient Registration Process required.--- Ability to understand variances in payer requirements based on type of service and/or procedure.--- Ability to effectively communicate payer requirements to patients and/or patients' family members.--- Ability to maintain quality standards and proficient performance standards during high activity and/or stressful situations.--- Above Average experience of computer applications and strong familiarity with access specific Internet Web sites for information. PI120345634

Keywords: Lags Spine and Sportcare Medical Centers Inc, Bakersfield , AUTHORIZATIONS CLERK, Other , Bakersfield, California

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