Job Type: Regular Scheduled Hours: 40 Job Summary: Reports to the Revenue Cycle Manager, the Referral/Auth Mgmt Specialist is accountable for a wide range of duties relating to the referral process as defined by the initial Scope of the Referral Mgmt-Auths Department. It is expected that the role of the Referral/Auth Mgmt. Specialist will evolve as the department expands and the central department absorbs additional office functions. The position is responsible for multiple cross-functional activities including: 1) Scheduling all specialty referrals (I.e. patient consultations, new patient visits and office visits), 2) Scheduling diagnostic tests, 3) Pre-certifications for diagnostic tests and procedures and 4) Pre-Authorizations for all specialist referrals. The Central Specialist will be expected to interact professionally with patients, SEP, independent physician offices, and insurance companies. Job Description: Job Title: Referral Authorization Management Specialist BENEFITS: - Work from Home Opportunity (Equipment Provided) - Paid Time Off - Medical, Dental, and Vision - 403b with Match - Opportunity for Growth DUTIES AND RESPONSIBILITIES: - Understand and uphold SEP’s Mission, Vision, and Values. - Comply with all applicable laws and regulations. - Schedules appointments for patients by phone when contacted by an office, by the patient directly, or by placing an outbound call directly to the patient. a. Uses manual/computerized system to match physician/clinician availability with patient’s preferences in terms of date and time. - Communicates as needed with physicians/clinicians and other staff about any patient concerns/issues related to scheduling. c. Communicate with patient as needed. - Monitors work queues in Epic relating to pre-certification/ pre-authorization and scheduling. - Completes pre-certification/ pre-authorization for tests, procedures, and referrals (If Applicable). - Communicates/ interacts with various insurance companies professionally and competently during the pre-certification/ pre-authorization process. - Verifies patient demographic information. - Verifies current insurance by recording insurance card and ensuring current updates in the practice management and electronic medical record systems. - Reminds patients of any outstanding balances. - Ensures completion of referral process, outpatient test scheduling, and pre-certification. - Ensures accurate and timely distribution of patient requests. - Works with central billing office as needed in a timely manner on all requests. - Uses customer service principles and techniques to deal with patients calmly and pleasantly. - Answers telephones within three rings and is helpful and friendly. - Other duties and responsibilities as assigned are complete on a timely, thorough and accurate basis. REQUIRED SKILLS AND KNOWLEDGE: Ability to manage and prioritize multiple tasks, strong working knowledge of Referrals, Pre-certification/ Pre-authorization, Customer Service, Outlook and the ability to learn other computer skills. Must have good organizational skills and work professionally with doctors, hospital administration, management, SEP employees and the public. OTHER REQUIRED SKILLS AND KNOWLEDGE: - Knowledge of current practice management and electronic medical record systems- Epic preferred (training provided). - Extensive knowledge of insurance plans accepted by SEP. - Extensive knowledge of referral process for insurance plans accepted by SEP. - Experience in a physician practice is preferred. - Demonstrated ability to work successfully in a team-based decision-making culture. - Demonstrated ability to work independently resulting in effective outcomes and on-time performance. - Experience in planning and coordinating multi-disciplinary communications strategies, strategic initiatives, and events. - Must respond and follow through to requests from customers promptly. - Must work carefully and precisely with attention to detail. - Must utilize resources wisely. - Performs duties willingly and with initiative. Shares necessary information so co-workers can do the same. - Cooperates with other departments and work groups. EDUCATION: Minimum: H.S. Diploma/GED Desired: Medical Office Experience YEARS OF EXPERIENCE: Less than 2 years of experience in healthcare, customer service, or other related field LICENSES AND CERTIFICATIONS: N/A FLSA Status: Non-Exempt Right Career. Right Here. If you have a passion for taking care of the community and are interested in Healthcare, you will take pride in the level of care we provide at St. Elizabeth. We take care of patients and each other. St. Elizabeth Physicians is an equal opportunity employer and will not discriminate on the basis of race, color, sex, religion, national origin, ancestry, disability, age or any other characteristic that is protected by state or federal law.

Job DetailsJob Location: Remote, LA - Franklin, TN 37067Position Type: Full TimeEducation Level: High School Diploma/GEDJob Category: Other PositionsUS Heart and Vascular is in need of a Remote Cardiology Prior Authorizations Specialist. If you have a passion for obtaining prior authorizations for Veins, Structural Heart and CT Studies, please join our US Heart and Vascular team Responsibilities: • Ensures timely and accurate insurance authorizations are in place prior to services being rendered. • Verifies insurance eligibility and benefit levels to ensure adequate coverage for identified services prior to receipt. • Responsible for verification and investigation of pre-certification, authorization, and referral requirements for services. • Coordinates and supplies information to the review organization (payer) including medical record information and/or letter of medical necessity for determination of benefits. • Collaborates with designated clinical contacts regarding encounters that require escalation to peer-to-peer review. • Communicates with patients, clinical partners, financial counselors, and others as necessary to facilitate the authorization process. • Appropriately prioritizes workload to ensure the most urgent cases are handled in a timely manner. • Completes accurate documentation in all applications. • Follows departmental policies and procedures, when necessary, authorization is not obtained before the service date. • Answers provider, staff, and patient questions surrounding insurance authorization requirements. • Handles escalated authorization requests as needed. • Provides team mentorship as needed. • Works other departmental tasks as needed. Requirements: • Familiarity with medical office procedures and billing practices • Proficient in clinical documentation review for alignment with insurance authorization requirements • Responsible for compliance with all regulatory requirements and/or guidelines. These requirements/guidelines include, but are not limited to: OSHA, HIPAA, Federal Fraud and Abuse laws. • High School Diploma or equivalent required • Associate’s degree in healthcare administration or business administration preferred • A minimum of 3-5 years' experience in the same role, or related field in a healthcare setting is required. • ECW experience is preferred. Qualifications

At Accendra Health, we understand that healthcare is complex, and we’re here to make it easier. We help deliver care beyond traditional settings, making essential products and services more accessible through every stage of life. As part of the care team, our teammates play a critical role in delivering personalized, long-term care for the patients we serve. With deep expertise promoting health outside the hospital and a presence in communities nationwide through our Apria and Byram Healthcare brands, Accendra Health does more than just deliver the essentials. If you’re interested in meaningful work with impact, explore our career opportunities and join us in our purpose of Bringing Care To Life™. The anticipated salary range for this position is $15.90 - $17.00 hourly. The actual compensation offered may vary based on job related factors such as experience, skills, education and location. JOB SUMMARY The Individual Contributor will provide excellent customer service and product information, solutions and relevant details to patients and providers. Most importantly, this position provides above and beyond communication with our patients so that they feel heard, understood, valued and more connected with Apria. Key responsibilities for creating a positive, patient-centric environment include: - Evangelize our customers and turn our disgruntled patients into our biggest fans. - Support our Field teams, Operations and Sales, by delivering timely feedback that empowers our teams to deliver exceptional patient experiences. - Critically problem-solve common complaints by flagging trends and partnering cross-functionally to recommend and implement preventative measures. - Proactively create a better patient experience. - Be a champion of the employee experience and drive our unique company culture. - Support the development and implementation of employee programs that nurture our company's core values to engage employees and create a positive culture. ESSENTIAL DUTIES AND RESPONSIBILITIES - Responsible for supporting hundreds of local branch offices across the country by reviewing new patients orders and documentation submitted by referral sources in order to obtain required documentation and clinical requirements of individual health insurance plans, allowing our patients to maximize their available health plan benefits and to receive the much-needed care as soon as possible. - Requests health plan authorizations/information as required; either electronically or verbally. - Demonstrates and ability to develop business relationships within the field leadership through close collaboration, partnership, engagement and communication. - Performs other duties as required. SUPERVISORY RESPONSIBILITIES - N/A MINIMUM REQUIRED QUALIFICATIONS Education and/or Experience - High school degree or equivalent - 1-3 years’ experience in healthcare/health insurance industry desired SKILLS, KNOWLEDGE AND ABILITIES - Patient-Focused: You start with the patient and work backwards. You invest the time and energy to understand the patients’ objectives, then tie all your activities directly to the achievement of those objectives. - Action-Oriented: You thrive as a self-starter who proactively senses and responds to problems and opportunities and requires minimal supervision. - Collaborative: You love teamwork. Your colleagues love having you on the team. You work well across functions and groups. - An Effective Communicator: You write and speak clearly, concisely and with a spirit of partnership. You actively inform and inspire with your messaging. You speak plainly and are transparent with your business colleagues. - Energetic & Passionate: Your passion and energy for health and well-being is deeply founded in your desire to help others and to be a positive role model. - Relationship Builder: You excel in getting people involved and building a network of contacts that allow you to multiply your influence on the organization. Certificates, Licenses, Registrations or Professional Designations - N/A Computer Skills - Intermediate skills in Access, Excel, PowerPoint, MS Project, Visio, Word Language Skills - English (reading, writing, verbal) Mathematical Skills - Intermediate level mathematical proficiency, with a strong ability to understand, interpret and develop spreadsheet data. PHYSICAL DEMANDS This is a stationary position that requires frequent sitting or standing, repetitive wrist motions, grasping, speaking, listening, close vision, color vision, and the ability to adjust focus. It also may require occasional lifting, carrying, walking, climbing, kneeling, bending/stooping, twisting, pulling/pushing, walking, bending, stooping, and reaching above the shoulder. This position also may require the occasional lifting of equipment up to 50 lbs. - This position is remote and requires a distraction free environment - Required to be in a home office/workspace during scheduled work hours OTHER INFORMATION The essential duties and responsibilities, physical requirements, and work environment described above are representative of those typically required for this position but may vary depending on staffing and business needs at specific locations. The inclusion or omission of a specific duty or physical requirement is, therefore, not determinative of whether that function is essential to a specific individual’s position. Reasonable accommodations will be provided to assist or enable qualified individuals with disabilities to perform essential functions. PLEASE NOTE: This is a remote position which is US-based. This role requires individuals to physically reside and work within the United States. Company systems and equipment are monitored for security and other purposes and removal of Company equipment outside of the United States is not permitted without prior authorization. Teammate Benefits As an Accendra Health employee, you have choices to fit your life. Our comprehensive benefits program is designed to meet you where you are — through all of life’s stages. We’ve got you and your family covered with benefits that support your health, finances, and overall wellness. Our benefits program includes: - Medical, dental, and vision care coverage - Paid time off plan - 401(k) Plan - Flexible Spending Accounts - Basic life insurance - Short-and long-term disability coverage - Accident insurance - Teammate Assistance Program - Paid parental leave - Domestic partner benefits - Mental, physical, and financial well-being programs If you feel this opportunity could be the next step in your career, we encourage you to apply. Accendra is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, sex, sexual orientation, genetic information, religion, disability, age, status as a veteran, or any other status prohibited by applicable national, federal, state or local law. Note: Accendra is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee at our Company via email, the Internet, or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of our Company. No fee will be paid in the event the candidate is hired by our Company as a result of the referral or through other means. #AccendraHealth

At Accendra Health, we understand that healthcare is complex, and we’re here to make it easier. We help deliver care beyond traditional settings, making essential products and services more accessible through every stage of life. As part of the care team, our teammates play a critical role in delivering personalized, long-term care for the patients we serve. With deep expertise promoting health outside the hospital and a presence in communities nationwide through our Apria and Byram Healthcare brands, Accendra Health does more than just deliver the essentials. If you’re interested in meaningful work with impact, explore our career opportunities and join us in our purpose of Bringing Care To Life™. The anticipated salary range for this position is $18.00 - $24.00 hourly. The actual compensation offered may vary based on job related factors such as experience, skills, education and location. ABOUT THE COMPANY Apria Healthcare’s mission is to improve the quality of life for our patients at home. We are looking for empathetic, thoughtful and compassionate people, to meet the needs of our patients. Already an industry leader in healthcare services, we provide home respiratory services and select medical equipment to help our patients sleep better, breathe better, heal faster, and thrive longer. JOB SUMMARY The Patient Services Specialist – After Hours will provide excellent customer service and product information, solutions and relevant details to patients and providers. Most importantly, this position provides above and beyond communication with our patients so that they feel heard, understood, valued and more connected with Apria. Key responsibilities for creating a positive, patient-centric environment include: - Evangelize our customers and turn our disgruntled patients into our biggest fans. - Support our Field teams, Operations and Sales, by delivering timely feedback that empowers our teams to deliver exceptional patient experiences. - Critically problem-solve common complaints by flagging trends and partnering cross-functionally to recommend and implement preventative measures. - Proactively create a better patient experience. - Be a champion of the employee experience and drive our unique company culture. - Support the development and implementation of employee programs that nurture our company's core values to engage employees and create a positive culture. ESSENTIAL DUTIES AND RESPONSIBILITIES - Act on behalf of the local branch offices after hours, and during weekends and Company holidays to accept urgent calls from patients and referral sources, troubleshoot equipment issues, handle urgent new patient set ups, or route/and dispatch local technicians or respiratory therapists, as needed, or to provide other necessary support. - Demonstrates and ability to develop business relationships within the field leadership through close collaboration, partnership, engagement and communication. - Performs other duties as required. SUPERVISORY RESPONSIBILITIES - N/A MINIMUM REQUIRED QUALIFICATIONS Education and/or Experience - High school degree or equivalent - 3-5 years’ experience in healthcare/health insurance industry or experience in dispatch or transportation SKILLS, KNOWLEDGE AND ABILITIES - Patient-Focused: You start with the patient and work backwards. You invest the time and energy to understand the patients’ objectives, then tie all your activities directly to the achievement of those objectives. - Action-Oriented: You thrive as a self-starter who proactively senses and responds to problems and opportunities and requires minimal supervision. - Collaborative: You love teamwork. Your colleagues love having you on the team. You work well across functions and groups. - An Effective Communicator: You write and speak clearly, concisely and with a spirit of partnership. You actively inform and inspire with your messaging. You speak plainly and are transparent with your business colleagues. - Energetic & Passionate: Your passion and energy for health and well-being is deeply founded in your desire to help others and to be a positive role model. - Relationship Builder: You excel in getting people involved and building a network of contacts that allow you to multiply your influence on the organization. Computer Skills - Intermediate skills in Access, Excel, PowerPoint, MS Project, Visio, Word Language Skills - English (reading, writing, verbal) Mathematical Skills - Intermediate level mathematical proficiency, with a strong ability to understand, interpret and develop spreadsheet data. PHYSICAL DEMANDS This is a stationary position that requires frequent sitting or standing, repetitive wrist motions, grasping, speaking, listening, close vision, color vision, and the ability to adjust focus. It also may require occasional lifting, carrying, walking, climbing, kneeling, bending/stooping, twisting, pulling/pushing, walking, bending, stooping, and reaching above the shoulder. This position also may require the occasional lifting of equipment up to 50 lbs. OTHER INFORMATION The essential duties and responsibilities, physical requirements, and work environment described above are representative of those typically required for this position but may vary depending on staffing and business needs at specific locations. The inclusion or omission of a specific duty or physical requirement is, therefore, not determinative of whether that function is essential to a specific individual’s position. Reasonable accommodations will be provided to assist or enable qualified individuals with disabilities to perform essential functions. Teammate Benefits As an Accendra Health employee, you have choices to fit your life. Our comprehensive benefits program is designed to meet you where you are — through all of life’s stages. We’ve got you and your family covered with benefits that support your health, finances, and overall wellness. Our benefits program includes: - Medical, dental, and vision care coverage - Paid time off plan - 401(k) Plan - Flexible Spending Accounts - Basic life insurance - Short-and long-term disability coverage - Accident insurance - Teammate Assistance Program - Paid parental leave - Domestic partner benefits - Mental, physical, and financial well-being programs If you feel this opportunity could be the next step in your career, we encourage you to apply. Accendra is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, sex, sexual orientation, genetic information, religion, disability, age, status as a veteran, or any other status prohibited by applicable national, federal, state or local law. Note: Accendra is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee at our Company via email, the Internet, or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of our Company. No fee will be paid in the event the candidate is hired by our Company as a result of the referral or through other means. #AccendraHealth