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Physician Authorization/Referral Specialist I
Location
United States
Posted
1 day ago
Salary
0
Seniority
Junior
Job Description
Physician Authorization/Referral Specialist I
Center for Health Care Strategies
• Ensure timely notification and request for authorization/referrals is handled in accordance with departmental policy and payor requirements. • Maintain confidentiality and verify patient demographics, insurance eligibility, benefits, and financial responsibility. • Ability to request/obtain authorizations/referrals for assigned specialties and cover for most specialties. • Communicate effectively, timely and professionally in writing and verbally. • Contact and interview families in person or by phone to obtain necessary information and assist with insurance issues. • Clearly document all communications and contacts with payors and families in standardized documentation requirements. • Consistently demonstrate excellent, empathetic and knowledgeable customer service skills. • Adhere to all State and Federal Regulations including, but not limited to: EMTALA, HIPAA, and the Joint Commission. • Ability to review workflows and suggest improvements in specialty areas. • Ability to work independently, prioritize workload, and assist other associates. • Build and maintain professional relationships with all departments that impact obtaining authorizations. • Prepare estimates for scheduled services, interpreting patient’s benefits for accuracy. • Work with partner hospitals for claim submission and registration accuracy.
Job Requirements
- Referral/authorization work experience required (minimum one year experience)
- High School diploma required
Benefits
- Health insurance
- Medicaid enrollment processes
- Supportive training for new team members
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