Referral and Authorization Coordinator - PRN

Benefits

• Competitive Health & Welfare Benefits
• $43 monthly stipend for ancillary benefits
• HSA with qualifying HDHP plans and company match
• 401k plan after 6 months of service with company match (including part-time employees)
• Employee Assistance Program available 24/7
• Employee Appreciation Days
• Employee Wellness Events

Minimum Qualifications

• Healthcare experience with Managed Care Insurance
• Experience with requesting Referrals, Authorizations for Insurance, and verifying Insurance benefits
• Minimum two to three years of experience in a healthcare environment in a referral, front desk, or billing role
• Effective communication skills with physicians, patients, and the public
• Working knowledge of Centricity Practice Management and Centricity EMR (a plus)

Essential Functions

• Verifies and updates patient registration information in the practice management system
• Obtains benefit verification and necessary authorizations (referrals, precertification) prior to patient arrival
• Uses online, web-based verification systems and reviews real-time eligibility responses
• Creates appropriate referrals to attach to pending visits
• Verifies patient demographic information and insurance eligibility including coordination of benefits
• Completes chart prepping tasks daily to ensure a smooth check-in process
• Researches all information needed to complete the registration process including obtaining information from providers, ancillary services staff, and patients
• Fax referral forms to providers that do not require any records to be sent
• Process 75-80 referrals on a daily basis for primary specialty office visits
• Notifies front office staff of outstanding patient balances
• Maintain satisfactory productivity rates and ensure the timeliness of claims reimbursement while maintaining work queue goals
• Respond to In-house provider and support staff questions, requests, and concerns regarding the status of patient referrals, care coordination, or follow-up status
• Identifies and communicates trends and/or potential issues to the management team
• Index referrals to patients' account for existing patients
• Create new patient accounts for non-established patients to index referrals