Location:

TriHealth Family Wellness Center possible remote work

Employment Type:

Full-Time Position Summary We are seeking a highly organized and detail-oriented Medical Assistant (MA) or Licensed Practical Nurse (LPN)/Registered Nurse (RN) to join our growing multi-specialty practice. This role is responsible for managing clinical communications, medication refill requests, referrals, insurance authorizations, and provider support to ensure efficient patient care and continuity of services. Essential Responsibilities Clinical Support Review and process medication refill requests under provider protocols. Answer pharmacy questions and coordinate with providers regarding prescriptions. Manage provider inbox tasks and clinical messages. Complete and process physician orders, forms, and medical documentation. Referral Coordination Process incoming referrals and schedule patients appropriately. Generate and coordinate outgoing referrals to specialists. Obtain insurance referrals and prior authorizations for medications, imaging, procedures, and specialty services. Follow up on referral status and communicate updates with patients and providers. Medical Records & Fax Management Review, prioritize, and distribute incoming faxes to the appropriate provider or department. Complete provider paperwork and return completed forms via fax. Maintain accurate documentation within the electronic health record (EHR). Insurance & Authorizations Verify patient insurance eligibility and benefits. Obtain prior authorizations for medications and medical services. Work with insurance companies to resolve authorization issues and denials. Experience with HMO referral processes is highly preferred. Patient Communication Communicate with patients regarding referrals, medication requests, authorizations, and documentation. Coordinate care between primary care providers, specialists, pharmacies, and insurance companies. Provide excellent customer service while maintaining HIPAA compliance. Qualifications Certified Medical Assistant (CMA/RMA), LPN, or RN required. Minimum of 2 years of experience in a medical office or outpatient clinic preferred. Experience with insurance verification, prior authorizations, referrals, and medication refill workflows . HMO referral and authorization experience strongly preferred. Knowledge of medical terminology, medications, and clinical documentation. Proficiency with electronic health records (EHR) and Microsoft Office. Strong organizational, multitasking, and communication skills. Ability to work independently in a fast-paced, team-oriented environment. Preferred Experience Multi-specialty clinic experience. Prior authorization platforms (CoverMyMeds, payer portals, etc.). Experience with Medicare, Medicaid, and commercial insurance plans. Familiarity with fax management, provider inboxes, and pharmacy communications. What We're Looking For Excellent attention to detail. Strong problem-solving skills. Ability to prioritize multiple tasks efficiently. Professional, dependable, and patient-focused. Positive attitude with a commitment to exceptional customer service.

Job Type:

Full-time Pay:

$13.00 - $20.00 per hour

Benefits:

Employee assistance program Employee discount Flexible schedule Flexible spending account Life insurance Paid time off Parental leave Professional development assistance Tuition reimbursement

Work Location:

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