Authorizations / Front Office Specialist

Large Specialty Medical Group is looking for an experienced Authorizations / Front Office Specialist for its Sacramento location.

POSITION SUMMARY

The Authorizations/Front Office Specialist is responsible for obtaining authorization as required for medical tests and/or surgical procedures as ordered by Sacramento ENT physicians as well as performing clerical and reception duties including, but not limited to, patient check in and check out, scheduling, eligibility verification, authorization and referral requests, collecting copays and balances on patient accounts, balancing and preparing daily batches and bank deposits. Maintains the facilities' medical records according to established guidelines and requirements.

ESSENTIAL FUNCTIONS

AUTHORIZATIONS

• Obtains and verifies authorization for new and return patient visits.
• Obtains and verifies authorizations for surgical procedures.
• Request authorization for Sleep Studies and durable medical equipment deemed necessary for              follow-up patient care.
• Outside Referrals to other facilities.
• Refer patients back to PCP's office if insurance dictates patient needs to be referred elsewhere.
• Obtains retroactive authorization when needed. 

FRONT OFFICE

Clerical

• Checking patients in and out
• Patients registration
• Answering multi line phone and routing calls appropriately
• Scheduling appointments
• Chart preparation
• Performs other duties as assigned.
• Processes cash receipts according to established policies and procedures.
• Reports malfunctioning equipment to appropriate personnel.
• Demonstrates awareness of protocol for malfunctioning equipment and repair.
• Available to work opening or closing shifts (between the hours of 6:30 AM and 6:00 PM)

Medical records management

• Follows established processes to obtain, manage and utilize patient information to enhance and improve individual and organizational performance in patient care.
• Provides for confidentiality, integrity and security of medical records.
• Facilitates timely and accurate medical records management.
• Ensures that each medical record contains the original documents as appropriate and available per established policy of medical record content.

Communication

• Listens respectfully, gives feedback directly, honestly and talks with others to clarify differences.
• Utilizes translation services when needed.
• Utilizes appropriate services when needed to communicate with employees and patients with speech and hearing disorders.
• Effectively communicates and interacts with patients, their family, and other external and internal clients (including fellow employees) from diverse backgrounds.

Quality

• Demonstrates a willingness to look at new ideas and work in a changing environment.
• Understands, verbalizes and participates in the quality improvement process.
• Supports initiatives designed to improve individual and organizational performance.

Access Control

• Payment Card Industry Data Security Standard (PCI DSS): Serves and protects the patient's private health and identifiable information by adhering to professional standards, policies and procedures, federal, state, and local requirements, PCI DSS, and HIPPA.
• Protected Health Information (PHI): Serves and protects the physician or health care provider practice by adhering to professional standards, policies and procedures, federal, state, and local requirements, and HIPPA.
• Additional security is outlined in the Access Control Policy by job role and can be located Company Intranet.

Other

• Other duties as assigned.

KNOWLEDGE, SKILLS AND EXPERIENCE

Minimum Education (or substitute experience) required:

• High School degree or GED

Minimum Experience required:

• Minimum of 2 years authorizations' experience in a medical or hospital setting and one (1) year experience in computerized appointment scheduling.

Travel:

• Ability to travel to and work at various office locations based on staffing needs and schedule
• A valid CA Driver's license is required

Skills/Knowledge/Ability:

• Interpersonal: Above average communication skills. Professional attitude and ability to establish and maintain effective relationships with staff, patients and public. Client oriented. Actively participates in the development of a healthy work environment. Uses interpersonal skills to establish and maintain healthy interpersonal relations, which include functional trust, positive feedback, and constructive criticism. Good communication skills: oral and written.
• Critical thinking: Ability to assess, prioritize, plan and implement tasks effectively. Ability to read, understand and follow oral and written instructions. Above average ability to handle multiple simultaneous tasks and phone calls while maintaining a professional courteous demeanor. Must be able to handle patient confrontations in a positive manner. Ability to handle emergency situations and have the ability to develop triage skills. Above average ability to problem solve, solution and detail oriented.
• Knowledge: Demonstrates knowledge of authorization procedures from running reports to obtaining authorization via phone or internet. Knowledgeable in reading and understanding reports to facilitate authorizations process. Knowledgeable in the use of medical management software to enter all necessary information on authorization status. Knowledge of medical terminology, health care environment and patient processing with computerized scheduling software. Knowledge of outpatient surgery forms, policies and procedures.
• Ability to type 40 wpm, use standard office equipment and be computer literate.

Current Openings for Authorizations / Front Office Specialist Jobs at Sacramento Ear, Nose & Throat