Eligibility and Authorization Specialist

Come and join our team! We are a local growing private medical practice specializing in the diagnosis and treatment of patients with diseases of the retina and vitreous. We are looking for individuals who would like to establish a career in healthcare working for a company with nationally recognized physicians. We provide on the job training giving you the ability to grow and advance your skills along with gaining innovative knowledge. Established in 1977, we have locations all over Northern California including Sacramento, Grass Valley, Roseville, Stockton, Modesto, Merced, Fairfield, Elk Grove, Folsom, Yuba City and Chico. Our physicians are nationally known, and we continue to be on the leading edge of retina care by utilizing the latest equipment and both participating in and designing new clinical trials to advance the state of care for retinal diseases. Join 240+ other team members working for our nationally recognized retina specialty practice. Possibility of remote work. Must be local to the Sacramento Area.

We are seeking a full-time Patient Eligibility and Authorizations Specialist to join our team. This will be a remote position after completion of training.

Responsibilities

• Verify eligibility and benefits through pharmaceutical company, electronically through Experian or via phone calls to insurance companies.

• Complete pharmaceutical companies online or paper eligibility and benefits requests.

• Provide co-pay assistance help to the patients- sending out packets, answering questions, enrolling online, and helping with information to qualify patients.

• Help patients who have no coverage for drugs to obtain free drugs from the pharmaceutical company.

• Order charity care and specialty pharmacy medication for patients that require it prior to their scheduled appointment.

• Maintain correct insurance information for the patient when working the appointments.

• Complete authorization requests through Samacare or insurance website. Add approved authorization information in NextGen.

• Complete the Appointment screen for high-cost medication approval.

• Answer the drug team queue calls from patients and clinics.

• Knowledge of insurances, i.e., HMO, GMC, PPO, etc.

• Computer skills including Microsoft Office

• Ability to navigate payer websites

• Technology savvy

• Communication skills—Able to communicate clearly with patients, payers, physicians and staff verbally and in writing

• Customer services skills

• Able to multi-task, and stay productive with frequent interruption

• Able to think ahead. i.e., what drug to use based on copayment assistance program

• Team player

• Able to work independently

Physical Requirements:

• Sitting and viewing computer screen for extended periods, up to 85% of the time
• Keyboarding, up to 90% of the time
• Standing, up to 25% of the time
• Close visual acuity required to perform duties such as viewing computer monitor, and determining accuracy and thoroughness of work

Full-time immediate employee benefits:
Paid Time Off (PTO) 13 days per year, as accrued.
7 Paid Holidays per year.
Scrub Allowance
Ability to participate in company 401k plan offered through Fidelity.

On the first of the month following 30 days of employment benefits:
Medical insurance – employer pays 95% of premium of base HMO plan for employee (dependent coverage available for purchase).
Group dental, vision, life, and accident plans available for purchase.
Flexible Spending Account participation available.
Allows pre-tax deferrals of amounts for medical, dental or vision premiums
Allows pre-tax deferrals for dependent care expenses, subject to limitations

After 90 days of employment – Paid Sick Leave of 5 days per year (California Residents Only).

After one year of service – 401K Plan Safe Harbor contribution (3% of annual earnings) received after plan year ends.