Authorization & Referral Coordinator Ii

3 weeks ago


Austin, United States Covenant Management Systems, L.P. Full time

**ABOUT AUSTIN REGIONAL CLINIC**:
**PURPOSE**

Under supervision of the Centralized Operations Manager, is responsible for obtaining authorizations and coordinating the care of patients that are referred to a specialist. May also be responsible for obtaining authorizations for medications. Acts as a resource for patients and staff with authorization and/or referral related questions/problems requiring resolution. Carries out all duties while maintaining compliance, confidentiality, and promoting the mission and philosophy of the organization.

**ESSENTIAL FUNCTIONS**
- Maintains current knowledge of insurance authorization and/or referral requirements.
- Obtains authorizations from insurance carriers in a timely and efficient manner.
- Acts as a resource for patients and staff with authorization and/or referral related questions/problems requiring resolution.
- Communicates authorization and/or referral information to patients and specialist offices in a timely and efficient manner.
- Serves as a liaison between Primary Care and Specialty offices.
- Reviews chart to determine appropriate clinical to send to insurance as requested.
- Can create, modify and sign referral orders within protocols.
- Assists patients with scheduling appointments into specialty locations.
- Responsible for coordinating medical record information for transmission to specialist’s office.
- Ensures authorization and/or referral information is properly documented in Epic.
- If aware, informs physician of patient compliance with referral plan.
- Informs physicians and management of any issues causing a delay in authorization process.
- Communicates changes and important information
- Works efficiently with all departments to promote teamwork within the organization.
- Attends Authorization Meeting regularly, and participates on sub-committees as needed.

QUALIFICATIONS

Education and Experience

Required: High school diploma or equivalent. Six (6) months or more experience working in the office of a healthcare related facility.

Preferred: Previous experience in insurance authorizations.

AND

Knowledge, Skills and Abilities
- Strong knowledge in business office functions and ability to serve as a resource to staff.
- Knowledge of medical insurance.
- Knowledge of medical terminology.
- Familiarity with procedural and diagnostic coding.
- Strong communication and interpersonal skills.
- Excellent computer and keyboarding skills, including familiarity with Windows.
- Excellent verbal and written communication skills.
- Ability to provide excellent customer service.
- Ability to analyze problems, make decisions, and manage conflict.
- Ability to engage others, listen and adapt response to meet others’ needs.
- Ability to align own actions with those of other team members committed to common goals.
- Ability to manage competing priorities.
- Ability to perform job duties in a professional manner at all times.
- Ability to understand, recall, and communicate, factual information.
- Ability to organize thoughts and ideas into understandable terminology.

**Work Schedule**:Monday
- Friday, 8am-5pm. Work from home opportunity once orientation complete.



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