Job Description

Job Description

Job Description

Under general supervision, performs all medication prior authorizations as needed. Ensures that referral and pre-authorization activities are undertaken in order to provide maximum patient and provider satisfaction and maximum reimbursement; and other duties as assigned.

ESSENTIAL FUNCTIONS

• Confirms insurance and demographic information is correct and accurate.
• Maintains knowledge of all payers’ guidelines.
• Reviews and extracts medical records to support medical necessity.
• Follows up to ensure all documentation is accurate and present.
• Works with patients, physicians and payers to resolve any denial issues.
• Communicates with physicians, surgical posters and patients of any possible authorization issues.
• Completes all prior authorizations after expiration date.
• Uses the electronic medical record as documented in the department and/or FPI standard operating procedure and processes.

EDUCATION and/or EXPERIENCE

• High school diploma or general education degree
• Two years related medical office experience
• Accurate data entry skills
• Current knowledge of payer requirements for referrals and preauthorization
• Knowledge of GE/IDX or similar computerized billing system
• General understanding of back office operations
• Strong customer service skills
• PC proficiency
• Medical terminology preferred

Total Rewards
The referenced base salary range represents the low and high end of University of Maryland’s Faculty Physician’s Inc. salary range for this position. Some candidates will not be eligible for the upper end of the salary range. Exact salary will ultimately depend on multiple factors, which may include the successful candidate's geographic location, skills, work experience, market conditions, internal equity, responsibility factor and span of control, education/training and other qualifications. University of Maryland Faculty Physician’s Inc. offers a total rewards package that supports our employees' health, life, career and retirement. More information can be found here: -employee-benefits

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