JOB SUMMARY:  The Care Authorization Specialist must be thorough, accurate and timely when reviewing and processing Veteran care referral requests and healthcare authorization forms to the Department of Veteran Affairs (VA) Medical Centers and community health care professionals.

ESSENTIAL JOB DUTIES:

• Review and process medical documentation from community providers following Veteran care and treatment. Transmit this information to the referring VA Medical Center to complete the Veterans medical record and ensure ongoing care coordination.
• Work with VA Care in the community staff and community medical offices to address and resolve any incomplete information required for Veteran treatment and care.
• Protect the health care privacy of patients by strictly following HIPAA regulations.
• Follow processes of the VA program and perform all tasks in a courteous and professional manner.
• Understand and work with standard coding systems including: standard medical taxonomy, International Classification for Diseases, Current Procedural Terminology, and Health Care Common Procedure Coding System.
• Work in a variety of systems to perform required tasks.
• Manage prioritized tasks in a time-sensitive environment.
• Perform other tasks as assigned by leadership.

EDUCATION AND EXPERIENCE REQUIREMENTS:

• Must have a high school diploma or G.E.D.
• College-level course work in the healthcare or equivalent field a plus
• Must have (1) one full year of experience working in a customer service environment.
• Must have experience with data-entry related to reasonably complex information such as medical records
• Must be proficient with a computer including Microsoft Office, the Internet, and other systems.
• Experience working in a healthcare environment a plus.
• Experience with medical terms (including the interpretation and use of ICD and CPT codes a plus

OTHER REQUIREMENTS:

• United States Citizenship Required
• Internal candidates must be in good standing and no active written corrective actions on file.

Required Skills Required Experience