Description

This position is for our brand-new stand-alone facility in Coral Gables, which will open in June 2023.

Location: 3737 SW 8th St, Coral Gables, FL 33134.

Position Summary:
The PG Authorization Clerk utilizes customer service skills and knowledge of the principles of managed care to respond to a variety of customer requests and support utilization management activities in a managed care environment. Must be able to demonstrate the abilities and skills necessary to facilitate the pre-certification of requested medical services through knowledge of clients benefits and the provider network; by providing support and education to internal and external customers, through conflict resolution and clear communication of information. This position acts in a confidential capacity to assist or aid department management. The position will have a significant role in processing confidential information.

Duties & Responsibilities:
Schedules ancillary services and other test at facilities. Inform patient the date and time of procedure. Faxes authorization requests with the doctors notes attached to the insurance company. Assures all requested authorizations have been approved. Demonstrates behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise). Performs all other related job duties as assigned.

Qualifications

Experience:
Generally requires 1 to 3 years of related experience.

Education:
High school diploma is required.

License Certification:
Valid license or certification is required as needed, based on the job or specialty.

Knowledge Skill Abilities:
Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines. Ability to communicate effectively in both oral and written form. Ability to handle difficult and stressful situations with critical thinking and professional composure. Ability to understand and follow instructions. Ability to exercise sound and independent judgment. Knowledge and skill in use of job appropriate technology and software applications.

Physical Demands:
Job function is sedentary in nature and requires sitting for extended periods of time. Function may require frequent standing or walking. Must be able to lift or carry objects weighing up to 20 pounds. Jobs in this group are required to have close visual acuity to perform activities such as: extended use of computers, preparing and analyzing data and analytics, and other components of a typical office environment. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC).

Work Environment:
Jobs in this group are required to function in a fast paced environment with occasional high pressure or emergent and stressful situations. Frequent interaction with a diverse population including team members, providers, patients, insurance companies and other members of the public. Function is subject to inside environmental conditions, with occasional outdoor exposures. Possible exposure to various environments such as: communicable diseases, toxic substances, medicinal preparations and other conditions common to a hospital and medical office environment. May wear Personal Protective Equipment (PPE) such as gloves or a mask when exposed to hospital environment outside of office. Reasonable accommodations can be made to enable people with disabilities to perform the described essential functions. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC).