Authorization Specialist/Medical Assistant- SOUTH
Asthma, Allergy, Immunology Division
Overview: The authorization specialist oversees the order process for patients on biologic therapies including infusion services. This role is responsible for communicating regularly with patients regarding the status of their order as well as coordinate with the authorization and clinical team to streamline the order process. This role is also involved with clinical triage and includes managing incoming patient phone calls from established patients with clinical questions and/or concerns as well as managing the patient portal. This individual should also be comfortable with daily medical assistant duties and can support the clinical team when needed.
Schedule: Monday-Friday, approximately 8:30-5:30pm. Hours and schedule may vary based on clinic needs.
· Communicate regularly with patients who are starting on new therapies, including but not limited to infusion services and biologic injections.
o Provide patient with a welcome call when a new therapy is ordered. Patient should be informed of the following:
§ General timeline and process for starting a new therapy and what next steps will be.
§ Provide patient with any support resources, copay assistance programs, etc. that are applicable to their therapy.
§ Obtain any medical records or additional clinical items to complete authorization checklist.
§ Communicate with the clinical team to confirm any missing items or needs before order is submitted to insurance.
o After the order has been submitted through the authorization team, the authorization specialist is responsible to continue an open line of communication with the patient, providing updates and estimated timelines as the process progresses.
o Coordinate peer to peer appointments or appeals as needed.
· Monitor daily open and pending orders. Communicate with the patient, clinical team, and authorization team to help streamline order process and decrease time from when order is submitted to patient starting therapy.
· Run weekly and monthly reports monitoring patients that have stopped or paused therapies. Provide support to help restart therapy or coordinate next steps.
· Coordinate scheduling new appointments once therapies have been approved or direct patients to the appropriate individuals to help schedule appointment.
· Schedule follow up appointments for therapies that have been denied. Communicate with patient regarding next steps and/or alternative options.
· Clinical triage
o Manage incoming patient phone calls directed to patients with clinical questions and concerns.
o Oversee the global portal by monitoring incoming patient messages throughout the day and responding appropriately.
o Complete incoming tasks directed toward the clinical team.
o Communicate with the clinical team and providers as needed for additional support.
· Room patients and perform necessary procedures prior to provider seeing patient including checking vitals, obtaining past medical history, reconciling medications, and reviewing drug allergies.
· Perform allergy shot and biologic injections.
· Enter orders on behalf of the provider including prescriptions, laboratory, radiology, and referrals.
· Complete diagnostic testing and procedures including breathing evaluations, skin testing, and point of care testing. Ensure appropriate charges are entered for specific procedure type and documentation is complete in the electronic health record.
· Schedule follow up appointments as indicated by the provider and assist with the checkout process for each patient.
· Assist with prior authorizations, medication refills, and various other administrative duties including scanning, faxing, and corresponding with other specialists or providers involved in patient’s care plan.
· Communicate with patients daily via phone and portal messages to provide updates on results, upcoming appointments, or other information provided by the provider to be relayed to the patients.
· Perform all injection types, both intramuscular and subcutaneously, and closely follow dosing instructions provided.
· Work collaboratively with other members of the clinical team including medical assistants, front desk members, and providers. Provider assignment may vary based on volume and staffing needs. Medical assistants should feel comfortable and willing to work with any of the providers on a day-to-day basis.
· Cleaning/stocking of rooms
Job Type: Full-time
Pay: $20.00 - $25.00 per hour
Expected hours: 40.0 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
- Wellness program
Weekly day range:
Experience:
- Insurance verification: 2 years (Preferred)
Ability to Commute:
- Centennial, CO 80112 (Required)
Work Location: In person