Job Description

2929 E Thomas Rd, Phoenix, AZ 85016, USA Req #387
Wednesday, January 18, 2023

About the Company:

District Medical Group (DMG) is well known as a respected leader in the healthcare industry in the Phoenix area, with a reputation for outstanding leadership, innovation and dedication to the patients and communities we serve. DMG employs over 650 credentialed providers and more than 350 professional/administrative staff as one of the largest physician groups in the Valley.


What Does DMG Offer?

DMG continuously strives for and succeeds in providing a strong and positive work environment through employee appreciation, team collaboration, competitive compensation, mentoring, and great benefits including:

  • A strong Healthcare benefits package inclusive of Medical, Dental and Vision- Employee eligibility effective DAY ONE
  • A rich 401(k) with employer match, increasing annually up to 6%
  • Flexible Spending Account plan
  • Generous Paid Time Off plan (3 weeks year one)
  • 10 paid holidays annually
  • Paid Sick Time
  • and more

 


About The Role: 

The Prior Authorization Coordinator 2 is responsible for reviewing prior authorization requests and following the internal authorization process.  This position manages a high call volume of prior-authorization and inbound referrals for specialists, surgery and radiology services.  The position reviews schedules with multiple patient's appointments, verifies or obtains authorization and  document authorization information. 

 

Schedule

This is a full-time position, Monday through Friday, 40 hours per week.  This is an on-site position.  Remote work is not available.

What Your Primary Responsibilities Would Be: 

 

  • Prioritizes incoming Prior Authorization requests.
  • Communicate authorizations and denials to ordering physicians. 
  • Keep records of schedules and authorization request. 
  • Maintain the databases of providers by health plan and specialty.
  • Maintains the ongoing sending and receiving faxes for future orders and reporting changes to specialist when completed.
  • Processes average of 300 incoming requests, including authorizing specified services, as outlined in departmental policies, procedures, and workflow guidelines.
  • Verifies members’ eligibility and enters information necessary to complete the request.
  • Accurately enter prior authorization information into the computer system.
  • Ensure appropriate feedback and follow-up with all prior authorization requests.
  • Efficiently and effectively navigate online payer websites for verifications.
  • Responsible for scheduling physician in-patient and out-patient procedures.
  • Verify insurance eligibility for the patient and obtain authorization for the procedure.
  • Communicate with patient to coordinate the scheduling of procedure, the designated facility and any pre-op instructions.
  • Assist and train new staff members.

 

The Successful Candidate Will Possess: 

  • High school diploma or equivalent required
  • 2 + years prior authorization experience preferred 
  • Bilingual Spanish/English preferred
  • 1 + years working knowledge of medical terminology, CPT and ICD-10 Codes.
  • Understanding/compliance of HIPAA laws and regulations.
  • Able to differentiate between primary and secondary insurance payers.
  • Computer proficiency (MS Office - Word, Excel and Outlook)
  • Excellent verbal and written communication skills, including ability to effectively communicate with internal and external customers.
  • Must be able to manage high call volume.
  • Must be well organized and detail-oriented.

 

 

DMG’s Employee Health Requirements:

As a condition of employment, District Medical Group (DMG) requires each employee to remain compliant with mandatory employee health (EH) standards. TB screening, Influenza, and Covid Immunizations or approved declinations are required for this role.

Other details

  • Pay Type Hourly
  • Min Hiring Rate $16.00
  • Max Hiring Rate $18.50
  • Required Education High School

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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