Summary

Responsible for accurate and timely analysis of the patient medical record, which is the communication tool to support delivery of optimum patient care by the clinician/provider. In a professional and courteous manner, generates calls to referring and/or specialty offices and other facilities to request records for the patient visit/test. Reviews documents received to determine if further reports are needed for the patient visit (i.e. bypass report from an out-of-state facility). Sends records to scan/index in a timely manner. Receives laboratory results and summarizes electronically to create a result trend of values. Responsible for accurately documenting pertinent authorization information in all related billing systems. Responsible for benefit verification for identified services and communicating benefit details to requesting department. Responsible for data integrity in all systems utilized for job functions. Responsible for evaluating each account individually, in a timely manner, to determine the appropriate precertification requirements based on established criteria. Is key to securing reimbursement and minimizing organizational write-offs by following up on denials and appeals to obtain approval from insurance companies. Responsible for answering department calls in a courteous manner and performing a quick release of information for continuity of patient care purposes. Responsible for delivering quality performance and service excellence while adhering to the Parkview Health Standards of Behavior.

Education

Must be a high school graduate or the equivalent with GED. Basic Medical Terminology desired. Must have completed a medical assistant program that meets certification eligibility requirements; OR must be a graduate of a school of nursing. Must complete General Orientation, Patient Care Orientation, and PPG practice orientation as provided and required.

Licensure/Certification

Must be a Certified Medical Assistant (CMA) through American Association of Medical Assistants (AAMA) or Registered Medical Assistant (RMA) through American Medical Technologists (AMT) or Certified Clinical Medical Assistant (CCMA) through National Healthcareer Association (NHA) or National Certified Medical Assistant (NCMA) through National Center for Competency Testing (NCCT) or Clinical Medical Assistant Certification (CMAC) through American Medical Certification Association (AMCA); OR must have current state Licensed Practice Nurse license. CPR required.

Experience

1-2 years prior authorization experience. Two to three years’ experience in a hospital or medical office setting desired. Experience with Microsoft suite of products preferred.

Other Qualifications

Requirements include the ability to perform at a high level and multi-task in fast paced environment; excellent communication, attention to detail, problem solving, troubleshooting, and time management skills. Must be able to adapt to constant change and perform in a stressful environment. Must have good verbal and written communication skills. Must be able to keyboard 35 words per minute. Ability to multi-task, work independently using critical thinking skills.

Why Parkview?

We have everything you’re looking for in a career; great compensation and benefits; skill development and career advancement programs and more. At Parkview, we are committed to providing excellent care to each patient within our clinics and medical practices. The success of this mission begins with care team members like you.

• Benefits: Health benefits, paid time off, employee assistance, community vendor discounts, payroll deduction options

• Sign-on bonus: For certified and uncertified Medical Assistants, LPN’s, and RN’s hired in part-time and full-time positions.

• Education: Clinical Orientation, tuition assistance, certification reimbursement

• Growth: Parkview’s Medical Assistant Advancement Pathway (MAAP)

• Culture: World-class teamwork, Personalized health journeys for co-workers and family member