Job Title

Medication Authorization Specialist

Reports To

The Medication Authorization Specialist position will report directly to the Administrative Manager.

Position Summary

Provides information on medication coverage, patient account status, and secures medical/clinical authorizations for services.

Responsibilities and Duties:

Secures medical/clinical authorizations for services.

• Obtain authorization via web/fax or phone.
• Document all pertinent communication with various parties not limited to pharmacy, physicians, health care facilities, insurance companies.
• Utilize clinical documentation and critical thinking to obtain authorization for all levels of patient care.
• Communicate with clinical staff on any issues as they arise, missing documentation, low medical necessity cases.
• Discuss medication, insurance, and authorization documents with patients.
• Appeal insurance companies after authorization refusal or denials.

Administrative Duties

• Updates/documents notes in excel team’s tracker with status and progress.
• Monitors the fax inbox/email/voicemails daily to ensure follow up completed in a timely manner.
• Assists in scheduling peer reviews in a timely manner to ensure continuous coverage.

Supervises, trains, orients assigned personnel.

Performs other job-related duties as assigned.

• Attends meetings as required.
• Adheres to HIPAA guidelines/regulations/annual HIPAA training.

Education

• Certified or Registered Medical Assistant. (1) two-year college degree or (2) completion of a specialized course of study at a business or trade school.

Work Experience

• One to three years of similar or related experience. Current CMA certification required

Knowledge

• Sound knowledge of medical terminology and billing.

Skills/Abilities

• Excellent oral and written communication abilities.
• Good interpersonal and public relations skills.
• Solid problem-solving skills.
• Attention to detail.
• Well organized.
• Able to correctly operate all related medical equipment.

Physical Requirements

• The work is sedentary. Typically, the employee may sit comfortably to do the work. However, there may be some walking, standing, bending, carrying of light items, driving an automobile, etc. No special physical demands are required to perform the work.

Interpersonal Skills

• Courtesy, tact, and diplomacy are essential elements of the job. Work involves much personal contact with others inside. and/or outside the organization for purposes of giving or obtaining information, building relationships, or soliciting cooperation.

  Benefits: Benefits Eligible

• For more information on UCF Health benefits including costs please go to: to: https://ucfhealth.com/careers/