Referral and Authorization Specialist
Referral and Authorization Specialist
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Salary Not Disclosed
1 Vacancy
Job Description
Overview
Enviromental Services Work
Full-Time; 32 hours per week; M-F Days
Obtains insurance eligibility benefits authorizations and pre-certifications for scheduled and non-scheduled visits. Updates demographic and insurance information in system as needed. Primary documentation source for access and billing staff. Resolve accounts on work queues. Interacts in a customer-focused and compassionate manner to ensure patients and their representatives needs are met.
Why UnityPoint Health
At UnityPoint Health you to be recognized as a Top 150 Place to Work in Healthcare by Beckers Healthcare several years in a row for our commitment to our team members.
Our competitive Total Rewards program offers benefits options that align with your needs and priorities no matter what life are just a few:
- Expect paid time off parental leave 401K matching and an employee recognition program.
- Dental and health insurance paid holidays short and long-term disability and more. We even offer pet insurance for your four-legged family members.
- Early accessto earned wages with Daily Pay tuition reimbursement to help further your career and adoptionassistanceto help you grow your family.
With a collective goal to champion a culture of belonging where everyone feels valued and respected we honor the ways people are unique and embrace what brings us together.
Andwe believe equipping you with support and development opportunities is a vital part of delivering an exceptional employment experience.
Find a fulfilling career and make a difference with UnityPoint Health.
Responsibilities
- Work with providers to assure that CPT and ICD-10 code is correct for procedure ordered and is authorized when necessary.
- Completes eligibility check and obtain benefits though electronic means or via phone contact with insurance carriers or other agencies and when necessary/requested provide initial clinical documentation.
- Initiates pre-certification process with physicians PHO sites or insurance companies and obtains pre-cert/authorization numbers.
- Perform follow-up calls as needed until verification/pre-certification process is complete.
- Thoroughly documents information and actions in all appropriate computer systems.
- Notifies and inform Utilization Review staff of authorization information to insure timely concurrent review.
- Validates or update insurance codes and priority for billing accuracy.
- Works with insurance companies to obtain retroactive authorization when not obtained at time of service.
- Work with billing team to provide education to patient access team regarding gaps or recurring issues and denials related to authorizations
- Complete patient scheduling
- Perform administrative tasks and ensure accurate data entry to facilitate timely and efficient care coordination.
Qualifications
Required:
- High school diploma or equivalent
- Ability to demonstrate strong customer service skills.
- Ability to effectively enter information into a variety of computer programs.
- Ability to understand and apply guidelines policies and procedures.
- Ability to interact effectively with physicians health care team members individuals and members of their support systems.
Preferred:
- Previous medical office experience preferred.
- Previous experience with an electronic health record or medical office software preferred.
- Knowledge of medical terminology anatomy and physiology.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
