Referral/Authorization Coordinator

Found in: Lensa US P 2 C2 - 2 weeks ago

Glen Burnie, United States Mercy Medical Center Full time

Overview:

The Referral/Authorization Coordinator is responsible for assisting the practice with the needs listed in the job description.

Responsibilities: Patient Scheduling from the practice In-basket: Reviews requests and approves appropriate appointments based on the providers scheduling preferences Calls patients and offers them an alternate appointment to those not falling within the providers scheduling preferences Reschedule canceled appointments as needed Confirm patients with a high No-Show rate Call and schedule patients from the previous day who do not have a follow-up appointment scheduled with our department If a patient declines or does not need a follow-up, they should be encouraged to schedule a physical within the next year Additionally, forward any CareFirst patients via email to our Care Coordinator Call and schedule patients from the TCM report

Billing Responsibilities: Charge Review WQ Venipuncture WQ Correct Pre-Op non-referring doctor report Prior Authorizations for each provider: Obtains prior authorizations for medications via Epic, contacting the insurance company, or com Updating the Provider, patient, and pharmacy of approval or denial status.

Referrals: Process referral requests according to policy and procedure Ensure referring offices receive referrals and any other necessary documentation to begin patient care Other duties as assigned: Assist with MA/ Providers In-Baskets Provide additional support if needed Other duties as assigned

Qualifications: Education: High School Diploma or GED History with obtaining prior authorization for medications Previous experience in a Medical Office is preferred Must be able to work independently and possess the ability to make independent decisions when circumstances warrant such action Must possess the ability to effectively communicate and deal tactfully with other personnel, visitors, patients, physicians, customers, and the general public Must be flexible, have personal integrity, and the ability to function effectively as a team with other employees Adapt to the changing needs of the organization, its patients and the market Actively contribute to a positive, congenial working environment Actively contribute to enhancing patient experience

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