Referral/Pre Auth Coordinator

Typical Hours

The hours of operation for the Gashland clinic are Monday-Friday, 7:30am-5pm. Your primary schedule will be during those hours, with periodic need to work outside your schedule to serve our patients.

Responsibilities

• Coordinating and ensuring referrals and/or pre-authorizations are managed and addressed appropriately.
• Works collaboratively with the health care team and the patient to schedule referral appointments, and independently completes the process for required pre-certification and prior authorizations in a timely manner.
• Provides quality service by acting as a liaison between healthcare team, patient and specialists to coordinate outpatient referrals and obtain pre-certifications or prior authorizations as necessary.
• Utilizes the EMR system to its full potential in capturing the necessary information needed for making an appointment and communicating necessary information such as referral requirements, patient demographic information, insurance and approval information, and comments about specific patient information key to a successful appointment.
• Provides education to patients about the importance of the referral process and service provided by the physician’s office, which may include subspecialty focus.
• Congnitionally coordinates efforts between providers, gathering and providing information key to appointment success.
• Communicates to physicians and other health care providers the various requirements and processes involved with medical referral authorizations for the most expedient patient appointment and successful visit.
• Completes the referral and/or preauthorization process by ensuring the specialists’ report or test results are received.
• Notifies the referring physician when a patient does not keep a referral appointment or a pre-authorization is denied.
• Marks incoming patient paperwork to be scanned and flags results that are to be reviewed by the physician.
• Completes FMLA, ADA and other medical paperwork as directed by the physician.

Requirements

• A high school diploma or equivalent.
• Minimum two years of experience in a physician office preferred.
• Working knowledge of medical terminology and knowledge of various insurance company requirements for pre-certification and referrals.
• Basic office skills, critical thinking, detail oriented and able to multitask in a fast paced environment.

Pay

Competitive wages.

Schedule

Day shift schedules.

Benefits

• Comprehensive Benefits (Medical, Dental, Vision, Life, FSA)
• Employer matched retirement plan
• Paid time off for personal/vacation/sick
• Six paid holidays per year