Duties and Responsibilities 

Primary Job Functions: 

• Responsible for reviewing, submitting, monitoring, and responding to issues regarding medication prior authorizations. 

• Reviews patient medical history to identify supporting documentation in the patient chart relevant to the medication. 

• Professionally communicates with prescribers, practice support staff, patients, and representatives of insurance companies; includes oral and written communication. 

• Responsible for contacting insurance companies via appropriate method to obtain prior authorization. 

• Updates information in the patient medical record with approval or declination information; follows up with ordering physician as to status of prior authorization. 

• Efficiently tracks pending authorizations for multiple offices/prescribers. 

• Creates a positive, professional, service-oriented work environment for staff, patients, and family members by supporting the mission and values of OGG. 

Secondary Job Functions: 

• Attends required meetings and training as requested. 

• Maintain confidentiality of patient and financial information by utilizing HIPPA guidelines and regulations. 

• Adheres to all Federal, State, and Local laws and regulations as well as policies set forth by Ohio Gastroenterology Group Inc, and its related parties. 

Knowledge, Skills, and Abilities 

• Knowledge of third-party payers and prior authorization requirements 

• Understanding of basic medical terminology and medications 

• Proficient use of office equipment, such as copier, fax machine, phones, etc. 

• Intermediate computer skills including use of Microsoft Office (Excel and Word), electronic mail, payer websites, physician practice management, and electronic medical record systems.  

• Strong time management skills 

• Ability to work independently with minimal supervision and to manage multiple priorities. 

• Strong written and verbal communication skills 

• Ability to effectively communicate with a variety of individuals. 

• Neat appearance, professional demeanor, and pleasant voice 

• Fluent in English 

Credentials and Experience 

• Must have a high school diploma or equivalent. 

• One (1) year of experience and relevant knowledge of insurance eligibility or prior authorization in a healthcare setting preferred. 

• Certified pharmacy technician, certified medical assistant, or licensed practical nurse preferred. 

Work Environment 

• Minimal medical office exposure that may require contact with adult patients 

• Office workstation environment with numerous employees 

Ohio Gastroenterology Group offers a nice life/work balance and a great benefits package that includes: 

• Medical, dental and vision coverage- benefits are effective the first of the month following 30 days of employment 

• Company paid life insurance and short term disability  

• Generous paid time off plans (vacation, sick and personal) 

• 7 paid holidays 

• Two retirements plans: 

• 401(k) plan that offers a 3% safe harbor contribution with immediate vesting as well as annual profit sharing contributions. 

• Cash balance pension plan – company contributes 2.5% and offers full vesting after 3 years of employment. 

• Tuition reimbursement programs 

• Employee appreciation programs 

• Uniform reimbursement programs  

• Growth opportunities 

• Learning and development training