Referral & Prior Authorization Specialist III

Job Location: 2337 Clinton Ave S, Brighton, New York, United States of America, 14618. Department: 400099 SMH Neurology Sleep Center. Worker Subtype: Regular. Time Type: Full time.

Responsibilities

• Serves as the patient referral specialist, with oversight of data and compliance to enterprise standards and referral guidelines.
• Communicates regularly with patients, families, clinical and non-clinical staff, identifying barriers to appointment compliance, insurance company barriers and tracking all assistance provided.
• Accountable for planning, execution, appeals and efficient follow through on all aspects of the process which has direct, multifaceted impact (quality, financial, patient satisfaction, etc.) on patient scheduling, treatment, care and follow up.
• Adheres to approved protocols for working referrals.
• Makes decisions that are guided by protocols and practices requiring some interpretation; maintains an expert level understanding of the department/division.
• May train new staff members.
• Responsible for managing department referrals.
• Serves as liaison, appointment coordinator, and patient advocate between the referring office, specialists and patient to assist in the coordination of scheduled visits and procedures incorporating all incoming referrals to the department using Epic Referral work queues