Job Title: Prior Authorization Representative
Department or Practice: All CHP Practices
Location: Great Barrington, MA
Level/Salary Range: Commensurate with experience
Position Type: Full- time, benefits eligible
CHP is seeking a Prior Authorization Representative who will be required to obtain prior authorizations for services performed by our providers. Promotes/supports quality effectiveness of Healthcare Services.
|Essential Duties and Responsibilities: other duties may be assigned|
- Efficiently obtain all authorizations for procedures to be performed prior to patients scheduled date of service.
- Notify scheduling staff of delays in obtaining these authorizations.
- Inform supervisor about any changes or patterns they are seeing in denials of procedures.
- Accept, handle, and process incoming patient telephone inquiries using appropriate customer service skills, clarify and validate patient inquiries, questions or complaints and correct and update patient account information in the computer system.
- Handle and process incoming patient correspondence. Correct or resolve issue, if possible.
- Provides clear explanations of appropriate patient-related policies.
- Maintains patient confidentiality in accordance with established policies.
- All other duties as assigned.
|Education and/or Experience:|
Massachusetts Medical Assistant Certification is preferred. Medical Office experience and/or experience as a Medical Assistant is required. Electronic record experience is a plus. Knowledge of medical terminology desirable; able to multi-task, prioritize with exceptional attention to detail.
|Competencies: To perform the job successfully, an individual should demonstrate the following competencies|
- High School Diploma – Medical Assistant certification desirable
- At least one year of experience with the insurance authorization process. Experience with medical terminology required.
- Strong organizational, judgment, communication and analytical skills.
- Ability to multi-task and perform multiple priorities.
- Cooperative and professional behavior toward patients, peers, providers, management and visitors.
- Ability to promote favorable image with patients, providers, insurance companies and general public.
- Ability to make decisions and solve problems.
- The ability to contribute in a team environment and/or independently, to provide excellent customer service.
- Working knowledge of Microsoft Office and Athena desired.
- Maintains confidentiality;
- Keeps emotions under control.
- Professional, welcoming personality.
- Contributes to building a positive team spirit.
|Oral and Written Communication:|
- Responds well to questions.
- Takes careful and accurate notes.
- Follows up on messages and ensures delivery of messages.
- Composes/types letters if requested by administration.
S/he must have the ability to read and comprehend simple instructions, short correspondence, and memos; ability to write simple correspondence; ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization. Spanish speaking/Bilingual skills are a plus.
To perform this job successfully, an individual should have knowledge of Microsoft Word and utilize Excel. Database skills are a plus.
To apply for this position please submit a cover letter, resume and application to:
|Email: firstname.lastname@example.org |
| Mail: Kelly Krok, Director, Human Resources |
Community Health Programs, Inc.
444 Stockbridge Rd. Great Barrington, MA 01230
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