Description

Purpose:
UPMC Tri Rivers Musculoskeletal Centers Authorization Team is hiring Specialty Procedure/Medical Authorization Coordinator for the Wexford, PA location. Monday - Friday daylight shifts!  The Authorization team working together to facilitate authorizing and scheduling all our patients’ Radiology Testing, FP procedure and specialty medication injections.  Performs authorizations for specialty procedures and medications with subsequent ordering of medications and patient scheduling. Responsible for a variety of clerical and administrative duties in support of the clinical support department.

Responsibilities:

• Obtains appropriate insurance authorizations for scheduled Fluoroscopic procedures.
• Contacts patients regarding authorization and schedule subsequent follow-up appointments.
• Various related responsibilities: Compiles and updates daily input rounding list for all hospitals and communicates details with physicians and midlevel providers. Files patient records, including OR pictures, in North Hills storage area. Provides support, including billing documentation, to Elizur for DME patients. Electronically files documents into patient files/folders. Calls rheumatology patients, or sends a message by mail, as a reminder for upcoming appointments. Communicates with rheumatology team regarding openings in the schedule for wait-list patients. Orders supplies for the North Hills clinical support teams from Staples and Aramark. Temporary indexer to cover absences. Works in conjunction with additional Specialty Authorization team members to assure consistent coverage for patients in regard to authorizing all categories of testing, procedure, and medication therapies. Performs other duties as needed and directed by management or team leader.
• Observes HIPAA and other privacy practices.
• Addresses patient messages using proper protocol to conclusion.
• Postal responsibilities: Retrieves UPMC mail and sends pictures and OR cards to surgical billing. Sorts and distributes contents of intra-office mail containers daily.
• Interacts professionally with carriers and vendors and correctly orders medication from appropriate vendor.
• Obtains appropriate insurance authorization for ordered visco supplementation and specialty drug injections.

Qualifications

• High school diploma or GED. 
• Minimum one year general clerical and computer experience. 
• Experience in a health care setting preferred. 
• Knowledge of operating system, scheduling and patient information preferred 
• Knowledge of electronic medical records systems preferred. 
• Knowledge of HIPAA rules and regulations. 
• 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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