General Purpose of the Job
To support patients and the clinical team by managing phone calls, medication refill requests and coordinating medication prior authorizations. This role serves as a clinical liaison between patients, pharmacies, providers, and insurance companies to ensure timely access to prescribed medications while maintaining compliance with regulatory and organizational standards. The Call Center Medical Assistant provides administrative and clinical support within scope by documenting patient-reported information, reinforcing provider-directed care instructions, and ensuring timely communication and follow-up. This role promotes patient satisfaction, continuity of care, and efficient workflow while maintaining compliance with organizational and regulatory standards.
Essential Duties & Responsibilities
- Receive incoming calls related to medication refill requests
- Review patient records for completeness and route refill requests to providers for review and approval
- Prepare and process refill requests in accordance with established workflows and provider direction
- Communicate with pharmacies and providers to clarify or resolve refill-related issues
- Provide patients with general information regarding refill processes and timelines
- Initiate, submit, and track medication prior authorizations with insurance payers
- Collect and document required information to support authorization requests
- Communicate authorization status to patients, providers, and pharmacies
- Follow up on pending or denied authorizations and escalate to appropriate staff as needed
- Receive incoming patient calls and accurately document patient-reported symptoms, concerns, and requests
- Route patient concerns to appropriate clinical staff (RN, provider) for review and follow-up
- Reinforce provider-directed instructions and care plans as appropriate
- Provide clear, professional, and empathetic communication to patients via phone and electronic messaging
- Collaborate with physicians, nurses, medical assistants, and administrative staff to support patient care coordination
- Address patient concerns related to medication access and insurance requirements
- Ensure adherence to HIPAA, organizational policies, and applicable regulations
- Accurately document all interactions, actions, and outcomes in the electronic health record (EHR)
- Meet established productivity, quality, and customer service benchmarks
- Demonstrate effective time management, organization, and attention to detail
- Maintain clear, accurate, and timely documentation
- Communicate effectively and work collaboratively within a team environment;
Supervisory Responsibilities
None
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience
High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience. AAMA (American Association of Medical Assistants) certification preferred.Necessary Skills & Abilities
Language Skills
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
Mathematical Skills
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Reasoning Ability
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
Computer Skills
To perform this job successfully, an individual should have basic to intermediate knowledge of Microsoft Office software (Outlook, Excel, Word), as well as Practice Management and Electronic Medical Record software.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is frequently required to use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand; walk; sit; reach with hands and arms; stoop, kneel, crouch, or crawl and taste or smell. The employee must occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, peripheral vision, depth perception and ability to adjust focus.
Travel
This job may require you to travel depending upon scheduling needs.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate.
May come into contact with human blood or other potentially infectious materials, which may result in possible exposure to blood borne pathogens (Category 1)