Prior Authorization Medical Assistant

Overview

Welcome to Sedona Management Solutions, your trusted partner in innovative technical solutions. We specialize in custom software development, medical billing, web, and mobile app development, all designed to help our clients achieve their goals with efficiency and precision.

Sedona Management Solutions is seeking a dedicated Virtual Medical Assistant/Prior Authorization Medications Assistant for a full-time position. As a Virtual Medical Assistant, you will be a primary contact for patients, responsible for managing medical office tasks, patient scheduling, record keeping, and daily communications. You will work closely with both patients and healthcare providers to create an organized, compassionate experience. This role requires availability to work the night shift (U.S. hours: 8 AM to 5 PM PST).

• Familiarity with EPIC EMR System or the ability to quickly adapt to EMR navigation.
• Experience managing inbound and outbound calls with a professional phone presence.
• Strong multitasking and time-management skills in a fast-paced environment.
• Proficiency in Medical Terminology and Medical Office Tasks.
• Excellent communication and interpersonal skills for effective interaction with patients and providers.
• Knowledge of medical billing processes is a plus.
• Nursing degree or Certification in Medical Assisting or a related healthcare field preferred.
• Demonstrated skills in Medical Assisting and Patient Care.
• Multispecialty medication / referrals experience.
• Medical authorizations experience.
• Good communication skills.
• Willing and able to do other related tasks as assigned. Cross-skilling is very likely to happen.

• Review and analyze patient medical records to determine the necessity of prior authorizations for various procedures and treatments.
• Communicate effectively with healthcare providers, patients, and insurance companies to gather required information and submit authorization requests.
• Maintain accurate documentation of all authorization requests, approvals, and denials in compliance with HIPAA regulations.
• Follow up on pending authorizations and resolve any issues that may arise during the approval process.
• Stay updated on changes in insurance policies, managed care requirements, and relevant medical coding practices (ICD-9, ICD-10).
• Collaborate with medical office staff to ensure seamless patient care and efficient processing of authorizations.
• Educate patients on the prior authorization process and any necessary steps they need to take.