Infojini
Medical Authorization Assistant
Infojini, Orange, California, United States, 92613
Duties & Responsibilities:• 85% - Medical Authorization Receives referral requests via fax, phone or electronically and enters new service request information into the authorization system.• Collects additional information from Client's Health members and providers to complete referral information.• Authorizes requested services according to Client's Health's authorization guidelines, performing data entry into the authorization system and verifying eligibility.• Contacts the health networks and Client's Health Customer Service regarding health network enrollments.• Assists the Medical Case Managers in gathering medical records, obtains appropriate coding for diagnosis and procedures and follows up on phone calls as directed by the authorization nurse.• Documents all contacts and case information in the system using the standard charting format.• Performs data entry into the appropriate databases for monitoring, tracking and trending of events and other relevant databases as needed.• Receives referral requests via fax, phone or electronically and enters new service request information into the authorization system.• Collects additional information from Client's Health members and providers to complete referral information.• Authorizes requested services according to Client's Health's authorization guidelines, performing data entry into the authorization system and verifying eligibility.• Contacts the health networks and Client's Health Customer Service regarding health network enrollments.• Assists the Medical Case Managers in gathering medical records, obtains appropriate coding for diagnosis and procedures and follows up on phone calls as directed by the authorization nurse.• Documents all contacts and case information in the system using the standard charting format.• Performs data entry into the appropriate databases for monitoring, tracking and trending of events and other relevant databases as needed.• 10% - Administrative Support• Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.• Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.• 5% - Completes other projects and duties as assigned.