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Call Taker

IHA

This is a Full-time position in Ann Arbor, MI posted November 20, 2021.

POSITION DESCRIPTION:

Responsible for reviewing, submitting, monitoring and responding to issues regarding medication prior authorizations for IHA patients. Reviews patient medical history to identify supporting documentation in the patient chart relevant to the medication; contacts insurance companies and obtains authorization for medication.

ESSENTIAL JOB FUNCTIONS:

  1. Responsible for reviewing, submitting, monitoring and responding to issues regarding medication prior authorizations for IHA patients.
  2. Professionally communicates with the ordering provider, practice support staff and representatives of insurance companies, including oral and written communication.
  3. Reviews patient medical history to identify supporting documentation in the patient chart relevant to medication.
  4. Contacts insurance companies via appropriate methods and obtains medication authorizations.
  5. 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.
  6. Monitors in basket, email, and fax server if applicable. Follows up on correspondence timely and accurately.
  7. Participates in data collection and data review assignments as required.
  8. Supports other offices, attends required meetings and training and participates in committees as requested.
  9. Performs other duties as assigned by Call Center leadership.

ESSENTIAL QUALIFICATIONS:

EDUCATION: High School Diploma

CREDENTIALS/LICENSURE : None

MINIMUM EXPERIENCE : Up to 3 years’ previous related experience in pharmacy or equivalent medical setting and/or prior authorization experience. CNAs welcome to apply.

POSITION REQUIREMENTS (ABILITIES & SKILLS):

  1. Proficient/knowledgeable in medical terminology.
  2. Proficient knowledge of major health plans and insurance processes.
  3. Proficiency in operating a standard desktop and Windows-based computer system, including but not limited to, electronic medical records ( EMR ), email, e-learning, intranet and computer navigation. Ability to use other software as required while performing the essential functions of the job.
  4. Excellent communication skills in both written and verbal forms, including proper phone etiquette. Ability to read, understand and respond to detailed written and oral instructions.
  5. Ability to work collaboratively in a team-oriented environment; displays courteous and friendly demeanor.
  6. Ability to work effectively with various levels of organizational members and diverse populations including IHA staff, providers, patients, vendors, family members, outside customers and community groups.
  7. Ability to cross-train in other areas of practice in order to achieve smooth flow of all operations.
  8. Good organizational and time management skills to effectively juggle multiple priorities, time constraints and ever-changing medical situations.
  9. Ability to exercise sound judgement and problem-solving skills.
  10. Ability to perform mathematical calculations needed during the course of performing basic job duties.
  11. Knowledge of the compliance aspects of clinical care and patient privacy and best practices in medical office operations.
  12. Ability to handle patient and organizational information in a confidential manner.
  13. Ability to travel to other office/practice sites and meeting and training locations.
  14. Successful completion of IHA competency-based program within introductory and training period.