PURPOSE: The Authorization Coordinator will document and process prior-authorizations for HMO Medi-Cal, Medicare, Medi-Medi and Commercial patients based on established policies, procedures and clinical guidelines. ESSENTIAL DUTIES: * Timely processing of prior authorization referrals from primary care physicians and specialists * Create deferral letters to obtain medical records * Prepare referrals for Medical Director denial review * Meet position performance and production standards MINIMUM REQUIREMENTS * Understanding of basic medical terminology * Organized, efficient and possess superior attention to detail * Punctual, prepared and able to meet or beat deadlines * Excellent written and verbal communication skills * Knowledge or experience in prior authorizations in the managed care setting a plus * Medical office experience a plus EDUCATION/TRAINING * High School diploma * College degree preferred * On Site training will be provided LANGUAGE SKILLS * Ability to communicate and speak effectively before co-workers, management, and external contacts * Ability to fluently speak, write, and understand English * Ability to write routine emails and other correspondence * Ability to speak clearly and concisely over the telephone CONFIDENTIAL AND SENSITIVE INFORMATION: * Must properly control the release of proprietary and confidential information Note that the information above is intended to describe the general nature and level of work being performed by employees, and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of the employer. Company Description Thrifty Management Services is the dedicated MSO for Preferred IPA of California, providing the best possible care management, care coordination, and claims processing services to Preferred IPA and their members. We work with the network's participating physicians to coordinate patient care when a referral is made to a specialist or hospital for diagnosis and treatment. We coordinate patient care across all aspects of the provider network. We provide high quality services to its participating physicians and superior health care to its members.
Thrifty Management Services is the dedicated MSO for Preferred IPA of California, providing the best possible care management, care coordination, and claims processing services to Preferred IPA and their members. We work with the network’s participating physicians to coordinate patient care when a referral is made to a specialist or hospital for diagnosis and treatment. We coordinate patient care across all aspects of the provider network. We provide high quality services to its participating physicians and superior health care to its members.