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Medical Pre-Authorization Clerk
Northern Virginia Pelvic Surgery Associates PC Fairfax, VA

Medical Pre-Authorization Clerk

Northern Virginia Pelvic Surgery Associates PC
Fairfax, VA
  • Vision , Medical , Dental , Life Insurance , Retirement
  • Full-Time
Job Description

Job Summary

The Medical Pre-Authorization Clerk role is a dynamic position on the front lines of serving our patients that requires multi-tasking, communication, and teamwork. We are a very busy practice and are looking for someone who is a fast learner, detail-oriented, can work under pressure, and will be a valued addition to our team. COVID-19 vaccination required.

Responsibilities and Duties

  • Calls insurances and pharmacies for pre-authorizations and schedules peer-to-peers, as necessary.
  • Verify coverage, benefits and eligibility for the patient with insurance company
  • Pre-Cert / authorization for upcoming surgeries with insurance company
  • Obtains clinical information required for review and documentation of precertification requests and routes to the appropriate individuals for processing.
  • Monitors e-fax, fax machines, and mail for authorization/re-authorization requests and routes information timely to the appropriate individuals for processes.
  • Answers inquiries from patients and providers and routes to appropriate physician.
  • Communicate authorization information to patients accurately and in a timely manner.
  • Effectively resolves inquires related to status of authorization requests.
  • Provides accurate and timely documentation to physicians for peer-to-peer consultation.
  • Use hospital or provider systems to locate appropriate patient details.
  • Respond to requests with the corresponding health information.

Qualifications and Skills

  • Previous pre-authorization experience required
  • Previous medical office experience - strongly preferred
  • Knowledge of medical terminology - strongly preferred
  • Knowledge of HIPAA - required
  • Provide excellent customer service, including compassion, ability to assess situations, identify concerns, and give timely follow up
  • Display a courteous and professional manner through interaction, appearance, attitude, and with written and oral communication with patients, third parties, co-workers, and physicians
  • Ability to protect and maintain the confidentiality of patient’s medical records and patient information, handling patient information with discretion and integrity
  • Ability to work efficiently in a fast paced, unpredictable (at times) environment
  • Strong organizational skills, time management, and multi-tasking abilities
  • Meticulous attention to detail
  • Proficient data entry skills
  • Strong computer skills, with ability to quickly master new systems and software, including EMR
  • Must be able to effectively use office technology, such as fax, copier, and scanner
  • High school graduate – required

Required experience:

  • Medical office pre-authorizations/clinical/records administration: 2 years required

Required education:

  • High school

Required work authorization:

  • Authorized to work for any employer in the United States


Northern Virginia Pelvic Surgery Associates PC

Fairfax, VA




Posted date

Over a month ago

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