Authorization, Pre-Cert, Scheduler

The CRMG APS Specialist processes orders placed by CRMG providers via CPOE in Athena Health EMR. The APS Specialist is expected to verify member eligibility via Athena Health EMR and will assure that the appropriate payers’ have been identified and payers’ requirements have been met. This position is also responsible for notifying the ordering provider if the patient has terminated coverage, any issues encountered with scheduling a referral or procedure/test. If applicable forward the order to Authorization Management in Athena Health EMR to document all events in Athena Health EMR by responding to request per CRMG workflows. The APS Specialist will be responsible for following through on every order to ensure that it was scheduled timely. They are not; however, responsible for verifying receipt of the result/procedure/surgery/consultation note or non-compliance letters. They are to coordinate with the CRMG providers on the provision of care to minimize the process necessary for the provider to achieve access for their patient. They will provide education to the CRMG provider and clinical staff regarding regulatory and process requirements. Other duties as assigned.