Referral Authorization Specialist
Referral Authorization Specialist
Posted on :
04-05-2025
Employer Active
1 Vacancy
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Job Description
Fulltime
Description
- Proactively reviews Occupational and Physical therapy schedules to determine which patients need referral or prior authorizations
- Verifies patient eligibility (insurance workers comp MVA)
- Prepares processes and tracks referrals and prior authorizations through various payer systems documents all in eCW per protocol
- Makes follow up calls to patients and payers (insurance company workers comp etc)
- Responds to questions and requests from leadership providers payers and patients
- Demonstrate professional communication and problem solving with providers and leadership participate in process improvement and educate teams on updated guidelines and/or process.
- Completes other tasks as directed by management.
- Attends staff meetings and continuing education
Requirements
- High school diploma required Bachelors degree in related field preferred
- Minimum of two years experience in medical and/or rehab billing and/or referrals/ prior auths
- Knowledge of medical terminology required
- Demonstrated ability to handle high volume of calls and claims in a fast paced environment
- Excellent verbal and written communication skills
- Strong computer skills including EMR and MS Office
Required Experience:
Unclear Seniority
Employment Type
Full-Time
Key Skills
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