Prior Authorization Clerk

Summary of Duties:
Creates a positive first impression of NRMC when greeting patients and other callers. Schedules patient appointments according to each departments preference and obtains the necessary information for new and established patients.

Essential Functions:
1.Answers the phone in a friendly manner.
2.Quickly determines the nature of the phone call and directs misrouted calls to the correct department.
3.Determines if an authorization is needed and ensures that an authorization has been obtained before scheduling.
4. Accurately enters patient information in the computer/scheduling program.
5. Obtains and accurately enters all insurance information into the registration.
6.Schedules patient appointments accurately according to the individual locations scheduling preferences
7.Informs all patients about payments that they may owe upon arrival.
8.Correctly cancels and reschedules appointments as needed.
9.Obtains benefit information from insurance companies specific to the service the patient is to receive in order to inform the patient of expected cost.
10.Maintains patient confidentiality

The above statements are intended to describe the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job.

Skills Abilities:
1.Ability to communicate clearly and effectively with all levels
2.Ability to perform simple mathematical equations.
3.Ability to prioritize and complete multiple tasks simultaneously.
4.Effective oral and written communication skills.

Working Conditions:
1.Exposure to distressed patients, families or visitors.
2.Possible exposure to inside environmental conditions.

Physical Demands:
1.Requires standing, sitting or walking for up to 8 hours or longer per workday.
2.The ability to lift up to 50 lbs.

Qualifications:
1.High school graduate or equivalent.

Preferred Qualifications:
1.2+ years of experience
2.Previous experience in appointment scheduling
3.Experience in customer service
4.Knowledge of medical terminology and familiarity with medical diagnostic procedures
5.Some knowledge of healthcare billing and authorizations.