Home Health Focus AI · 1 day ago
Authorization Specialist-Medications I "Potentially Remote"
Ann Arbor, MI
Full-time
Remote
Entry Level
1+ years exp
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Responsibilities
Reviews patient medical history to identify supporting documentation in the patient chart relevant to the medication.
Responsible for reviewing, submitting, monitoring and responding to issues regarding medication prior authorizations for Hiring Company patients.
Professionally communicates with the ordering provider, practice support staff and representatives of insurance companies, including oral and written communication.
Contacts insurance companies via appropriate methods and obtains medication authorizations.
Updates information in patient medical record in EPIC (EMR) with approval or declination information; follows up with ordering physician as to status and/or issues with prior authorizations.
Efficiently tracks pending authorizations for multiple offices.
Monitors in basket, email and fax server if applicable. Follows up on correspondence timely and accurately.
Participates in data collection and data review assignments as required.
Supports other offices, attends required meetings and training and participates in committees as requested.
Performs other duties as assigned by Call Center leadership.
Qualification
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Required
High School Diploma
1-3 years’ previous related experience in pharmacy or equivalent medical setting and/or prior authorization experience.
Proficient/knowledgeable in medical terminology.
Proficient knowledge of major health plans and insurance processes.
Ability to successfully process medication authorizations for up to 4 offices, typically in the same division.
Proficiency in operating a standard desktop and Windows-based computer system.
Preferred
Prior Authorization Certified Specialist (PACS) certification recommended
Knowledgeable in Microsoft 365 (especially Excel)
CNAs welcome to apply
Company
Home Health Focus AI
HomeHealthFocus.ai is an innovative data platform that tracks and analyzes critical information from home care, hospice, and senior living companies across the United States.
2-10 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase
