Konza Prairie Community Health Center
Prior Authorization Specialist
Konza Prairie Community Health Center, Junction City, Kansas, United States, 66441
Job Type
Full-time
Description
We are seeking a highly motivated Prior Authorization Specialist to join our team. This role is responsible for overseeing all aspects of prior authorizations, the referral process, and medical correspondence/records, ensuring efficient and accurate task completion.
ESSENTIAL JOB FUNCTIONS:
Work with third parties (insurance companies, hospitals, imaging facilities) to obtain prior authorizations and schedule patient medical services. Process, maintain, and close prior authorizations. Follow up with specialty provider offices and close referral loops upon receipt of consult notes or result documentation. Categorize and assign incoming lab and diagnostic imaging orders with results to the appropriate provider. Handle refill requests from outside pharmacies and correspond accordingly to address tasks. Maintain third-party sites for shared patient medical records to promptly close referral loops. Prioritize and process referrals based on urgency or PCP request. Perform prior authorizations for outbound referrals and diagnostic imaging. Manage medical records by sorting, filing, and collecting documents such as admission slips, lab reports, pathology reports, operative notes, clinic notes, and discharge summaries, ensuring proper sequencing and adherence to procedures. File and retrieve medical records while researching lost or missing records as needed. Review patient medical records for completeness and follow up on missing documentation. Manage incoming faxes by categorizing, distributing, and attaching documents to appropriate parties according to established priorities and procedures. Participate in quality improvement activities. Perform other duties as assigned by the supervisor. Requirements
High school diploma or GED required. Minimum 1 year of experience with electronic medical records required. At least 2 years of face-to-face experience with medical patients preferred. At least 4 years of customer service experience preferred. Knowledge of healthcare payment methodologies, including Medicare, Medicaid, HMOs, PPOs, and secondary payers, preferred. Minimum 1 year of experience in a family practice or hospital setting preferred. Completion of a certified medical office training course preferred.
Join our team at Konza Prairie Community Health Center and experience a workplace that truly values your well-being. We take pride in offering a comprehensive range of employee benefits designed to support your health, financial security, and work-life balance. Here's what you can expect: Medical, Dental, and Vision Coverage:
Take advantage of our robust health plans to ensure you and your family's well-being. Paid Time Off (PTO):
Generous PTO accrual of up to 7.71 hours per pay period for a healthy work-life balance. 403(b) Retirement Plan with Employer Match:
Secure your financial future with our retirement savings plan, complemented by employer contributions. Employee Discounts:
Insured employees and their immediate family members can enjoy exclusive discounts when utilizing Konza's in-house medical, dental, and pharmacy services. Early Friday Closure:
Konza clinics close at 2 pm every Friday, allowing you to kick off your weekend early.
At Konza, we are committed to fostering a workplace that celebrates diversity and inclusivity. We believe in the power of different perspectives, backgrounds, and experiences to drive innovation and success. We are an Equal Opportunity Employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.
Full-time
Description
We are seeking a highly motivated Prior Authorization Specialist to join our team. This role is responsible for overseeing all aspects of prior authorizations, the referral process, and medical correspondence/records, ensuring efficient and accurate task completion.
ESSENTIAL JOB FUNCTIONS:
Work with third parties (insurance companies, hospitals, imaging facilities) to obtain prior authorizations and schedule patient medical services. Process, maintain, and close prior authorizations. Follow up with specialty provider offices and close referral loops upon receipt of consult notes or result documentation. Categorize and assign incoming lab and diagnostic imaging orders with results to the appropriate provider. Handle refill requests from outside pharmacies and correspond accordingly to address tasks. Maintain third-party sites for shared patient medical records to promptly close referral loops. Prioritize and process referrals based on urgency or PCP request. Perform prior authorizations for outbound referrals and diagnostic imaging. Manage medical records by sorting, filing, and collecting documents such as admission slips, lab reports, pathology reports, operative notes, clinic notes, and discharge summaries, ensuring proper sequencing and adherence to procedures. File and retrieve medical records while researching lost or missing records as needed. Review patient medical records for completeness and follow up on missing documentation. Manage incoming faxes by categorizing, distributing, and attaching documents to appropriate parties according to established priorities and procedures. Participate in quality improvement activities. Perform other duties as assigned by the supervisor. Requirements
High school diploma or GED required. Minimum 1 year of experience with electronic medical records required. At least 2 years of face-to-face experience with medical patients preferred. At least 4 years of customer service experience preferred. Knowledge of healthcare payment methodologies, including Medicare, Medicaid, HMOs, PPOs, and secondary payers, preferred. Minimum 1 year of experience in a family practice or hospital setting preferred. Completion of a certified medical office training course preferred.
Join our team at Konza Prairie Community Health Center and experience a workplace that truly values your well-being. We take pride in offering a comprehensive range of employee benefits designed to support your health, financial security, and work-life balance. Here's what you can expect: Medical, Dental, and Vision Coverage:
Take advantage of our robust health plans to ensure you and your family's well-being. Paid Time Off (PTO):
Generous PTO accrual of up to 7.71 hours per pay period for a healthy work-life balance. 403(b) Retirement Plan with Employer Match:
Secure your financial future with our retirement savings plan, complemented by employer contributions. Employee Discounts:
Insured employees and their immediate family members can enjoy exclusive discounts when utilizing Konza's in-house medical, dental, and pharmacy services. Early Friday Closure:
Konza clinics close at 2 pm every Friday, allowing you to kick off your weekend early.
At Konza, we are committed to fostering a workplace that celebrates diversity and inclusivity. We believe in the power of different perspectives, backgrounds, and experiences to drive innovation and success. We are an Equal Opportunity Employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.