Referral Authorization Specialist
Lifepoint Health® · Hancock, MI · 4 wk ago
On-siteHealthcarePart-time
About the role
A Referral Authorization Specialist who excels in this role:
Responsibilities
- Completes pre-authorizations for all diagnostic testing, therapy, surgical and specialty care appointments according to insurance requirements within 3 days of issuance.
- Notifies patient when referral is approved and notifies Provider if denied or if a second opinion or additional information is required.
- All communication with patient, nurse, and/or Provider will be documented in the clinic EMR.
- Updates to referrals will be made in the EMR each time communication is had with patient, insurance provider, nurse, or Provider.
- Maintains up-to-date knowledge of all health care plans and interprets and communicates plan policies and procedures to employees, physicians and (patients) when they have changed.
- Identifies and attempts to resolve patient's barriers to specialty care, including assisting with scheduling appointments and helping to coordinate with specialist offices.
- Assists in tracking high-priority referrals to ensure patients in high-risk categories receive necessary follow up care.
- Performs administrative or clerical duties as assigned, including filing, reception, scheduling, data entry, and patient registration.
Qualifications
- Education: Highschool diploma required. Associates Degree preferred
- Minimum Work Experience: 1 year experience in a Medical office setting preferred
- Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
- Must be able to work in a stressful environment and take appropriate action.
Benefits
- Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
- Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
- Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
- Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
- Professional Development: Ongoing learning and career advancement opportunities.