This is a full-time Prior Authorization Specialist position.
Job Specific Competencies:
- Completes each prior authorization and patient assistance reference encounter in an efficient, standardized and accurate manner.
- Demonstrates professionalism and provides exemplary customer service with each encounter for both internal and external customers.
- Demonstrates exceptional organizational skills.
- Conducts all activities with the highest standards of professionalism and confidentiality.
- Complies with all applicable laws, regulations, policies and procedures, supporting JCMG’s corporate integrity efforts by acting in an ethical and appropriate manner.
- Assist with medication refills within clinic guidelines.
- Provides nursing care to patients in the clinic following the Missouri Licensed Practical Nurse Practice Act, scope of practice.
- Provides appropriate safety and infection control measures.
- Performs routine clerical activities required for efficient operation of the ambulatory clinic.
- Assures the efficient and effective functioning of clinic processes.
Knowledge/Skills/Abilities:
- Knowledge of Managed Care contracts/plans
- Medical terminology
- Excellent organizational skills, written and oral communication and customer service
- Strong teamwork and collaborative skills
- Ability to multi-task and work independently as this is a fully remote position.
- Attention to detail
- Must have knowledge of office equipment and computers
JCMG Core Competencies:
- Strives for continuous quality improvement.
- Participates in educational experiences designed to maintain and/or improve professional competence.
- Maintains high work ethic standards.
- Provides quality customer service to staff, patients and visitors at all times.
MINIMUM QUALIFICATIONS
Education:
- High school diploma or GED
- Graduate from an approved Licensed Practical Nurse School of Nursing
Experience:
- 1 year in an acute care setting; prefer an additional 1 year in ambulatory care
- Minimum of 1 year experience in managed care or medical office environment
- Computer experience required
WORK ENVIRONMENT
Works in heated and air-conditioned area; may be exposed to infectious material and contagious conditions; frequently exposed to patient body fluids, including blood and contaminated sharps; potential for exposure to hazardous disinfecting chemicals and radiation; must follow universal precautions and utilize personal protective equipment.
BENEFITS
- Health insurance & employer paid short- and long-term disability
- Generous PTO policy, beginning at 148-hours annually
- 56 hours paid Holiday Leave
- Employer Retirement Plan (401K) with employer match
- Tuition reimbursement and other professional advancements, including a Medical Assistant training program
Active LPN education/license per Missouri practice act, 1+ year acute care experience (ambulatory/managed care preferred), computer proficiency, knowledge of managed care and medical terminology, strong organization and communication skills.
Key Responsibilities
- processing authorizations
- providing nursing
- documenting encounters
Job Details
- Category: Healthcare Services - Nursing
- Seniority: Entry Level
- Commitment: Full Time
- Workplace: Remote — Jefferson City, Missouri, United States
- Languages: English
Benefits
- 401k matching
- Generous paid time off
- Tuition reimbursement
- Retirement plan
About Jefferson City Medical Group (JCMG)
A medical group providing ambulatory clinical and dermatology services with a focus on quality and patient care. — Industry: Healthcare