Prior Authorization Representative Jobs in Michigan

Transend MSO, Inc. provides administrative support to New Oakland Family Centers who offers top-tier psychiatric care, therapeutic counseling, and educational services to individuals and families. We are committed to providing consistent, compassionate support, responding to each person's needs, and treating everyone with the highest level of respect through active engagement in our communities.

Position Details

Schedule: Full-time, shift-based schedule as determined by the Director or Supervisor, including one required weekend shift per month.

Reports to: Director of Clinical Resources / Call Center Supervisor / Call Center Manager

Compensation: Hourly Employee; $18 hour. Commensurate with experience.

Position Summary

The Call Center Representative plays a crucial role in ensuring seamless access to New Oakland Family Center's services by professionally responding to all incoming inquiries and requests. The representative must prioritize excellent customer service and demonstrate adaptability to varying call volumes. Effective communication and adherence to organizational protocols are essential to delivering a high-quality experience for consumers and staff.

Key Responsibilities

• Assist with scheduling and rescheduling all routine and non-routine medical services for all New Oakland locations.
• Promptly and professionally answer calls, complete phone intakes, and handle medical service requests and inquiries, including verifying and rescheduling appointments and initiating treatments.
• Verify Medicaid insurance and assists with other billing matters when required.
• Communicate clearly and professionally with consumers and staff, providing pre-visit instructions, directions, and relaying provider instructions.
• Demonstrate flexibility in providing call center coverage through scheduling adjustments for absences, events, or call volume changes.
• Assist with completing and overseeing data entry into tri-county dispatch system.
• Assist with providing coordination between emergency departments, inpatient hospitals, schools, families, therapists, and NOFC ICS services.
• Process medication refill requests accurately and efficiently, ensuring timely response to consumer and pharmacy inquiries.
• Manage prior authorization requests by gathering necessary information, coordinating with providers, and following up to ensure approval.
• Participate in team meetings, support a collaborative environment, and provide flexible coverage.
• Maintain a positive, adaptable attitude, embrace learning opportunities, and implement feedback for professional growth.
• Stay current with professional training requirements.
• Perform other duties as assigned to support clinic operations.
  

Working Conditions

• Employees are expected to maintain a professional appearance in alignment with the Employee Handbook and be prepared for active engagement with consumers.
• This role requires extended periods of remaining in a stationary position during HIPAA-compliant communications and requires the ability to perform physical activities such as bending and reaching. Reasonable accommodations can be provided to enable individuals with disabilities to perform these essential functions as needed.
• The workspace must maintain a quiet and professional environment including minimizing noise and distractions to ensure a safe, confidential and supportive atmosphere for consumers in accordance with professional and ethical standards.
• Proficiency in using computers, phones, and office equipment for documentation and telehealth purposes is necessary. This includes but is not limited to Office 365 and Electronic Medical Record systems.
• The role may require moving within the office or traveling between locations to fulfill job responsibilities. Reasonable accommodation will be considered based on individual needs.
  

Qualifications

• High school diploma or equivalent required.
• Strong communication and coordination skills, with the ability to work effectively with diverse populations.
• Proficiency in data entry and electronic medical records (EMR) systems preferred.
• Ability to work in a fast-paced environment while maintaining professionalism and customer service focus.
  

Desired Skills

• Strong multitasking abilities, with effective time and project management skills.
• Ability to work collaboratively within a multidisciplinary team.
• Excellent written and verbal communication skills.
• Exceptional attention to detail and accuracy.
• Ability to effectively engage diverse populations, including children, adolescents, and adults.