Description
Purpose:
UPMC Tri Rivers is hiring full-time authorization specialist for special testing and physical therapy for the Wexford office. Performs authorizations and coordinates patient ordered specialty testing dates and follow-up.
Responsibilities:
- Obtains PT referrals as needed for specific carriers for external facilities.
- Contacts patients regarding authorization and testing and follow-up appointments.
- Addresses patient messages using proper protocol to conclusion.
- Works in conjunction with additional Specialty Authorization Team members to assure consistent coverage for patients in regards to authorizing all categories of testing, procedure and medication therapies.
- Schedules patient testing with specific facilities utilizing hospital/facility protocols and processes.
- Obtains appropriate insurance authorizations for MRI/CT testing for all insurance carriers.
- Performs other duties as needed and directed by management, team leader or physician.
- Observes HIPAA and other privacy practices.
Qualifications
- High School diploma or GED. One year experience in a similar position.
- Medical office experience preferred.
- Knowledge of current operating system (Misys) and EMR system (SRS). Knowledge of the Navinet system for health care administration.
- Knowledge of Microsoft Word and its functions
- Knowledge of telephone equipment and its functions (transferring, placing on hold, etc.)
- Knowledge of basic office procedures.
- Skill in utilizing all above systems to achieve essential job functions.
- Skill in verbal and written communications.
Licensure, Certifications, and Clearances:
- Act 34
UPMC has a Center for Engagement and Inclusion that is charged with executing leading-edge and next-generation diversity strategies to advance the organization’s diversity management capability and its national presence as a diversity leader. This includes having Employee Resource Groups, such as PRIDE Health or UPMC ENABLED (Empowering Abilities and Leveraging Differences) Network, which support the implementation of our diversity strategy.
- UPMC is an Equal Opportunity Employer/Disability/Veteran
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