Clerk - Authorization Center

Description

Job Summary: The professional will be responsible for ensuring quality patient service, managing procedure authorizations, and organizing medical records, aiming for efficiency and compliance. Key Highlights: 1. Friendly and efficient patient service 2. Management of procedure and material authorizations 3. Resolution of medical record pending items to prevent claim denials Description: * Currently pursuing a technical education in related fields; * Prior experience of 6 months in related activities is desirable; * Intermediate computer skills; * Provide friendly and efficient patient service, suggesting procedural adjustments when such procedures are inconsistent with required practices to ensure service quality and institutional standards; * Forward authorization requests for procedures (e.g., hospitalization, diet, wound care, high-cost exams, surgeries, special materials and medications) to the Authorization Center, and verify materials and medications dispensed from the pharmacy against medical prescriptions and nursing notes documented and justified in the medical record, including required signatures and supporting evidence; * Perform daily verification of completion and organization of medical records for inpatients across units, ensuring adherence to processing deadlines to enable timely billing; * Resolve pending items in medical records returned by the Accounts Review Department to prevent claim denials by health plans, thereby avoiding financial loss to the institution; * Deliver patient discharge documents from units to the Accounts Review Department for verification and billing processes; * Monitor receipt of requests sent to the Authorization Center to attach formalized authorizations to medical records; 2511270202401889401