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Authorization & Referral Liaison

2 months ago

Las Vegas, United States UNLV Medicine Full time $19 - $22
Job DescriptionJob Description

The Authorizations & Referrals Liaison receives incoming phone calls for clinic appointments from patients, nursing staff, and physicians. Responsible for the complete and accurate processing of appointment scheduling, pre-registration, insurance verification, and pre-authorization. The A&R Liaison will work pre-authorization work queues and resolve any pending referral requests.

The A&R Liaison is responsible for timely patient follow up with the patient as they call requesting a time estimate on the referral process. The Authorization and Referral Specialist PSR must have the ability to track existing referrals by program and payer in the Epic system and insurance portals to be able to provide a patient response that builds confidence and creates an environment of commitment to excellence. The Authorization and Referral Specialist position requires excellent customer service skills with patients, employees, and the public. Individuals must also be flexible, organized and must be able to manage a demanding workload with accuracy in a fast pace environment.

ADVANTAGES OF WORKING FOR UNLV HEALTH

  • Clinic Hours are Monday through Friday, 8AM to 5PM (Actual hours may vary depending on business need)

  • 12 Paid Holidays per year, starting with your first day of employment
  • 20 + PTO days per year (Depending on Position)
  • 3% 401K Contribution, even if you do not contribute
  • Medical, Dental, and Vision benefits that start the first of the month following your start date
  • Pay may be higher than listed range, based on years of experience
  • And more

MAJOR RESPONSIBILITIES

  • Authorizations and Referrals
    • Schedules new patient referrals to clinical programs ensuring clinician eligibility for payer.
    • Initiates authorizations for services as requested by clinical staff and as required by payer.
    • Verifies non-clinical content on all authorizations/referrals prior to submitting to the payer to ensure all required data fields are complete and accurate.
    • Submits prior authorization requests to the payer.
    • Ability to maneuver the EMR system to answer the patients questions as they call in to the PSR (A&RS) in order to provide prompt follow up without placing the patient on hold or transferring the call. If additional time is needed to research the referral issue then the patient will be told that a call with follow up will occur by the end of the business day.
    • Responds to patient questions directly by researching the correct information and if further research is needed then allow time to call the patient back by the end of the shift.
    • Retrieve and responds to messages left on voicemail every 2 hours throughout 8 hour shift
    • Checks and responds to patient portal messages in Epic every 2 hours throughout 8 hour shift
    • Manage and work the referral & preauthorization work queues
    • Validate and collect information required for incoming referrals and prior authorization then schedule
    • Validate requirements and process outbound referrals and prior authorizations within specified timeframe
    • Functions effectively in a Matrix Management environment.
    • Completes any duties and special assignments as requested.
    • Assists with training as needed.
    • Treats all internal and external customers with respect at all times
    • Manages conflict calmly and with empathy.
    • Completes any duties and special assignments as requested.
  • General Duties
    • Maintains an organized, clean and presentable work area
    • Participates in job related training and meetings as assigned
    • Maintains active knowledge and understanding of contracted payers and service limitations
    • Knowledge of medical terminology required
    • Good communication and customer service skills required

EDUCATIONAL REQUIREMENTS

  • High school graduate or equivalent

QUALIFICATIONS

  • Two years in the medical field to include front office, appointment scheduling and referral authorization
  • Must be Bilingual English/Spanish
  • Knowledge of health plans, eligibility and guidelines
  • Demonstrated ability to read, write and speak English
  • Demonstrated ability to use a computer
  • Minimum typing speed of 35 wpm
  • Knowledge of ICD-10 and CPT billing codes is a plus
  • Medical Terminology, MS Word, MS Excel.

PHYSICAL REQUIREMENTS

  • May include standing, sitting, and/or walking for extended periods
  • May include performing repetitive tasks
  • May include working with challenging patients and clients
  • May include lifting up to 25 pounds
  • Ability to use logic reasoning for simple and complex problem solving

UNLV Health will provide equal opportunity employment to all employees and applicants for employment. No person shall be discriminated against in employment because of race, color, gender, age, national origin, ancestry, religion, physical or intellectual disability, marital status, parental status, sexual orientation, or any other category protected by law.

If you have any questions about our interview and hiring procedures, please contact Recruitment at healthjobs@medicine.unlv.edu .