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Senior Medical Authorization Specialist

  • LocationCordova, TN 38016 - United States
  • Work TypeFull time
  • Positions1 Position
  • Published At:6 days ago
  • Job no: 39119
  • Category: Other

Job Description

Our client, a leading medical device company, is currently seeking an accomplished Senior Medical Authorization Specialist to join the team. Here is an overview of the role:

1) Review and interpret medical record documentation for patient history, diagnosis and previous treatment plans

2) Utilize payer-specific approved criteria to determine medical necessity or the clinical appropriateness for the company’s products

3) Submit pertinent demographic and supporting clinical documentation with pre-authorization requests timely to avoid unnecessary delays inpatient treatment

4) Maintain and document complete, timely and accurate patient billing information

5) Perform an ongoing check and balance system to ensure the integrity of the patient billing data

6) Operate compliantly at all times by keeping patient data secure and confidential and adhere to all company’s policies and procedures

7) Work with the Order Management Team to secure any additional information and medical documentation from the patient and prescribing HCP

8) Assist with order escalations to ensure the appropriate payer guidelines have been applied

9) Review payer denials

10) Prepare and submit appeals on behalf of patients

11) Comply with all health, safety and environmental policies, procedures and job hazard analyses applicable to specified job activities

12) Complete all required training in a satisfactory and timely manner

13) Hold oneself and others accountable to conduct business in a manner compliant with the company’s code of compliance, policies and procedures and internal controls applicable to their role

14) Perform other duties as assigned


Critical Requirements

1) Appropriate full-time work experience is mandatory (no students or fresh graduates please)

2) Recent experience in the medical device industry is strongly preferred

3) Preference will be given to candidates with recent experience in medical authorization

This role is a great opportunity for the right person looking to advance their career with a wonderful company. If you are qualified and think that you are a strong fit for this role, please apply ASAP!

Compensation and Other Details

Base Salary: Highly competitive package, commensurate with experience

  • Published on 14 Oct 2021, 1:11 PM