Referral Prior Authorization Rep
1 month ago
Overview: Looking to be part of something more meaningful? At HonorHealth, you’ll be part of a team, creating a multi-dimensional care experience for our patients. You’ll have opportunities to make a difference. From our Ambassador Movement to our robust training and development programs, you can select where and how you want to make an impact.
Join us. Let’s go beyond expectations and transform healthcare together.
High School Diploma or GED Required
Experience
6 months in a medical office Required
Licenses and Certifications
Must demonstrate proficiency in Electronic Health Record post hire by attending required training and passing proficiency test. Required
Responsibilities**:Job Summary**
The Referral Coordinator-PN is responsible for coordinating all aspects of specialty referrals, eligibility verification and maintenance for practice patients. This responsibility includes obtaining client information, maintaining patient files, verifying information with appropriate agencies, and reporting statistics and data as required.
- Processes and approves selected specialists referrals according to criteria and guidelines established in general and PN specifically.
Obtains referral request documentation
Completes referral authorization/prior authorization in a timely fashion and in accordance with practice requirements.
Compiles all pertinent medical data and supporting documentation and faxes or mails to appropriate receiver.
Verifies eligibility, benefits and contractual appropriateness.
- Responsible for recording referral information on Referral Log in order to assist in the tracking of referral numbers and costs to assist in budgetary forecasting and to assure follow-up.
- Responsible for Electronic Health Records:
Continually maintains Health Insurance Portability and Accountability Act (HIPAA) and other compliance requirements.
Enters non-clinical information into patient electronic health record (EHR) system. Ensures all required information is keyed in thoroughly and accurately.
Views non-clinical information in patient EHR system.
Independently formulates information to be entered into EHR system.
Obtains information to be entered from multiple sources such as providers, nurses, etc.
Logs, tracks, and resolves issues within specific time frame to ensure accuracy and timeliness of data entry.
Brings errors and/or issues to the attention of designee.
Navigates through multiple complex EHR screens and enters data.
- Performs other duties as assigned.
Facility: HH Medical Group Support Department: Med Group Business Ops Work Hours: 8am - 4:30pm Shift: 01 - Days Position Type: Regular Full-Time
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