Job Description

JOB SUMMARY/ESSENTIAL JOB FUNCTIONS: The Medical Administrative Assistant 3 provides administrative support for the Inborn Errors Diet Treated program and Inborn Errors Enzyme Replacement Therapy in the Department of Pediatrics.



DUTIES AND RESPONSIBILITIES:

Completes necessary forms for Prior Authorizations requests (Cigna, AR Medicaid, TN Medicaid, etc.).
Contacts insurance carriers to acquire necessary information for peer-to-peer, troubleshoots issues with insurance carries, and organizes and submits information for appeals.
Submits requested clinic notes, letters of medical necessity or other information to insurance carriers.
Checks status of Prior Authorization requests for approvals/denials.
Contacts parents or patient to obtain new insurance information.
Obtains authorization for medications and related services (e.g. home health/infusion center when needed) for patients with chronic infusion therapies.
Works closely with the case managers at pharmaceutical companies to receive assistance for patients' needs.
Retrieves faxes and follows-up to provide the requested information for medications and related services.
Obtains and maintains prior authorization for medical foods and low-protein foods, enzyme replacement therapies, drugs and replacement micronutrients for children with inborn errors of metabolism.
Updates matching of Durable Medical Equipment, insurance companies, and products (medical foods, low-protein foods).
Maintains updated demographic sheet of active patients.
Inputs monthly, biweekly, FMLA, and temporary employee timesheets using SAP.
Performs other duties as assigned.


MINIMUM REQUIREMENTS:

EDUCATION: High School Diploma or GED. (TRANSCRIPT REQUIRED)

EXPERIENCE: One (1) year of experience; OR Associate’s Degree in lieu of experience.

KNOWLEDGE, SKILLS, AND ABILITIES:

Knowledge of medical terminology.
Experience with medical insurance/or equivalent training is preferred.
Knowledge of Microsoft Office products including Excel.