Medical Assistant Infusion Medication Authorization Specialist

Job Description
Do you enjoy working with friendly and helpful people in a positive work environment? Are you ready to embrace a career that offers a variety of learning opportunities? Are you looking to make a positive impact on peoples' lives in our community?

Consider a career in the medical field at Boulder Medical Center . We're an independent, multi-specialty, outpatient network of providers and staff dedicated to engaging our patients in high-quality, compassionate health care. For over 70 years, BMC has been locally owned and operated, providing exceptional medical care to patients across the northwestern Front Range and surrounding communities. This unique business model is why many of our employees come and stay!

Job Summary

Boulder Medical Center is currently seeking a Medical Assistant to work as a Medication Authorization Specialist in our Infusion clinic. This position will work 16-20 hours per week.

Job Duties:

Performs daily review of incoming requests for pre-authorizations for prescription medications and biologics for insurance products.

Handles pre-certification process required by most insurance companies for non-formulary medications; Completes correct documentation in patient's medical chart.

Responds to phone calls from BMC physicians, nurses, and staff with managed care insurance questions regarding medications, investigates problems or inquiries by contacting appropriate insurance company, and communicates action or resolution to staff in a timely and professional manner.

Answers routine managed care insurance questions from patients referring them to the appropriate insurance company or to their employer when necessary for further benefit information or interpretation of policy.

Communicates with patient to address and/or clarify problems or concerns; Communicates action back to ordering provider in a timely manner.

Investigates and prepares appeals when claims are denied; Notifies health plan with appeal and notifies patient of appeal process and outcome.

Works closely with BMC's insurance companies via phone, fax, or written correspondence regarding effective/termination dates and pre-authorization problems; Researches source documents, including review of patient's medical chart, submits information necessary to resolve initial inquiry and receive payment.

Competently operates the Electronic Medical Records system; Attends mandatory EMR training and participates in on-going EMR learning opportunities.

Experience and Skills
Skills and Abilities:

Must be knowledgeable about managed care insurance rules and regulations in order process referrals and pre-authorizations.

Must be able to analyze detailed breakdowns of applicable managed care insurance coverage and use judgement and initiative in researching questionable charges and coverage.

Must have accurate typing skills, strong computer knowledge and experience operating office machines such as printers and fax machines.

Must possess basic math aptitude, professional manner, tact, pleasant telephone voice, ability to initiate correspondence using appropriate grammar, etc., ability to communicate appropriate insurance policy rules to patients .
Education:

Holds an active license for either Medical Assisting or LPN.
Previous Experience:

1-2 years' experience working with managed care insurance rules and regulations or equivalent.

Demonstrated working knowledge of ICD-10 coding.
Salary Range

$17.36 - 24.61/hour; depending on experience
Location:

Boulder, CO

Job Benefits
BMC offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and STD as well as voluntary benefits, RTD EcoPass, 401, Paid Time Off and 6 paid holidays annually. Part-time employees are eligible for medical/dental/vision, company-paid life insurance, voluntary benefits, RTD EcoPass, and 401.

Job Details:

Posted Date : 2022-04-21

Expiry Date : 2022-07-21

Job type : Part Time