Description
The Authorization Technician provides support by handling all administrative and technical functions of the authorization process including intake, logging, tracking and status follow-up.The Authorization Technician collects information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory time lines by maintaining an accurate database inventory of referral authorizations, retrospective reviews, concurrent reviews and grievance/appeal requests, and prepares Activity and Weekly Compliance Reports.
In addition, the position performs data entry and processing of referrals/authorizations in the system, authorizes request consistent with auto auth criteria, maintains confidentiality when communicating member information, and assists with the communication of determinations by preparing template letters for members/providers, with other duties as assigned.
SKILLS:
EDUCATION:
Required: High School Diploma
Preferred: Associate or Bachelor's degree preferred.
LICENSES/CERTIFICATIONS:
Required: Medical Terminology
Preferred: CPT/ICD.9 coding
EXPERIENCE:
Required: At least one year of experience in Medi-Cal managed care authorization processes and/or as a Medical Assistant; knowledge of medical terminology and ICD-9 and CPT codes; strong verbal and written communication skills; proficiency with Microsoft Word, Excel, and Access; and excellent organizational, interpersonal and time management skills. Must be detail-oriented and an enthusiastic team player. Knowledge of MHC and/or CSIIM computer systems a plus.
Preferred: Knowledge of MHC and CSIIM computer system.