Outpatient Referral & Authorization Representative-6500

Kingman Regional Medical Center (KRMC) is the largest healthcare provider and the only remaining not-for-profit hospital in Mohave County, Arizona. As a 235-bed multi-campus healthcare system, our medical center includes more than 1,900 employees, 270 physicians/allied health professionals, and 150 volunteers. KRMC is recognized as an innovator in rural healthcare and a teaching hospital, providing a full continuum of highly technical and specialized medical services to meet community healthcare needs. Year after year, the Leapfrog Group has awarded KRMC an "A" Grade for Patient Safety, and Becker's 2025 list named us one of the "Top 100 Greatest Community Hospitals" for dedication to clinical excellence.

About the role

This position is responsible for financially clearing all outpatient referrals as ordered by the referring provider. Responsibilities include processing referrals within the provider EMR, verifying insurance eligibility and benefits, contacting patients to discuss coverage, obtaining authorization when necessary, maintaining statistical information regarding payers, communicating with providers and staff about denials, and documenting and scanning all communication into the referral and EMR. You will provide guidance to the department and provider office representatives as needed, establish and maintain inter-departmental communication within the hospital, and work closely with Medical Office Coordinators to address issues affecting orders. Other duties may be assigned.

Responsibilities

• Process outpatient referrals within the provider EMR
• Verify insurance eligibility and benefits
• Contact patients to discuss coverage
• Obtain authorization when necessary
• Maintain statistical information regarding payers
• Communicate with providers and staff about denials
• Document and scan all communication into referral and EMR
• Provide guidance to department and provider office representatives
• Establish and maintain inter-departmental communication within the hospital
• Collaborate with Medical Office Coordinators on issues affecting orders

Requirements

• High school diploma or equivalent, or 2-5 years of healthcare experience in lieu of education
• Minimum of six months of progressive work experience
• Strong communication skills
• Ability to operate computer and software applications
• Attention to detail managing multiple priorities and tasks

Work Environment

• Primarily desk-based with frequent use of computer and phone
• Some bending, walking, and reaching required
• Sits for 90% of the day
• Occasional, non-routine exposure to biohazards and hostile individuals is possible

Benefits

• Health and Well-Being:
  • Medical, Dental, and Vision coverage
  • Employer-paid HSA for HDHP participants
  • Robust Wellness and Employee Assistance Program
  • Employer-paid Group Life, Short & Long-Term Disability
• Paid Leave:
  • Generous paid leave accruals
  • PTO cash-out opportunities
• Retirement:
  • 403b Retirement Plan with employer contributions
• Additional Perks:
  • Employee Recognition Programs
  • Employee Discounts
  • Employee Referral Bonus Program
  • Employee Identity Theft Protection
  • On-site daycare exclusive to employees’ children of all ages
  • On-site Wellness Center with fitness classes, personal training, indoor pool, racquetball, and basketball courts
• Career Growth and Development:
  • Tuition Reimbursement/Scholarships for full-time employees
  • Eligibility for Public Service Loan Forgiveness program for qualified student loans

Schedule

Full-time, Monday–Friday, day shift

Kingman Healthcare, Inc. does not provide visa sponsorship for this role.