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Surgical Referral and Authorization Coordinator
2 months ago
Benefits:
- Salary $18-20
- Supporting CISH ( Core Institute Specialty Hospital) and Elevation Surgery centers
- Competitive Health & Welfare Benefits
- Monthly $43 stipend to use toward ancillary benefits
- HSA with qualifying HDHP plans with company match
- 401k plan after 6 months of service with company match (Part-time employees included)
- Employee Assistance Program that is available 24/7 to provide support
- Employee Appreciation Days
- Employee Wellness Events
Minimum Qualifications:
- Must have Healthcare experience with Managed Care Insurance, requesting Referrals, Authorizations for Insurance and verifying Insurance benefits.
- In-depth knowledge on insurance plan requirements for Medicaid and commercial plans.
- Minimum two to three years of experience in a healthcare environment in and prior auth experience
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 for all ambulatory visits, procedures, injections, and radiology services
- Uses online, web-based verification systems and reviews real-time eligibility responses to ensure accuracy of insurance eligibility.
- Creates appropriate referrals to attach to pending visits.
- Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
- Completes chart prepping tasks daily to ensure smooth check-in process for the patient and clinic.
- Researches all information needed to complete registration process including obtaining information from providers, ancillary services staff and patients.
- Fax referral form to providers that do not require any records to be sent. Be able to process 75-80 referrals on a daily basis. For primary specialty office visits, fax referral/authorization form to PCPs and insurance companies in a timely fashion.
- Reviews and notifies front office staff of outstanding patient balances.
- Maintains satisfactory productivity rates and ensures 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 management team.
- Index referrals to patient accounts for existing patients.
- Create new patient accounts for non-established patients to index referrals.
- The job holder must demonstrate current competencies for job position.
