Medical Authorization Assistant at Ultimate Staffing Services in Orange, California

Job Description:

Medical Authorization Assistant
6 month contract
M-F 8AM-5PM
$23.92-33.48


Summary


The Medical Authorization Assistant will provide office and case management support services by serving as a contact between members, physicians, nursing home facilities, community-based organizations, providers and staff. The incumbent will complete initial intake of information, assist with authorization functions and gather information. The incumbent will perform under the direction of the licensed Medical Case Managers, Social Workers, Program Mangers and department managers. The incumbent will provide effective and efficient communication with the utmost courtesy in every interaction with our members, employees and other customers.


Responsibilities


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.
Receives cases via mail, fax, phone or electronically and enters data for new case information into the medical management systems.
Conducts individual interviews with members and/or providers to obtain intake information and gather data.
Works with the Medical Case Manager to authorize requested services according to department guidelines and verifies eligibility through the state systems.
Contacts the health networks and/or Customer Service department regarding health network enrollments, changes in address and primary care provider.
Assists in gathering medical records, obtaining appropriate coding for diagnosis and procedures and follows up on phone calls.
Documents all contacts and case information in the appropriate medical management system using the standard charting format.
Performs data entry into the appropriate databases for monitoring and tracking, trending of cases and other relevant databases as needed.
Generates monthly and other required reports from the databases as requested by the Medical Case Manager and/or health networks.
Sends letters to providers and members.
Answers calls and provides customer service to providers and members, provides care coordination and refers the callers to the correct department.
Completes other projects and duties as assigned.


All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance. For unincorporated Los Angeles county , to the extent our customers require a background check for certain positions, the Company faces a significant risk to its business operations and business reputation unless a review of criminal history is conducted for those specific job positions.