Referral Authorization Specialist
Referral Authorization Specialist
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Salary Not Disclosed
1 Vacancy
Job Description
Who We Are:
People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. National Park Medical Center a 163-bed full-service hospital is a forward thinking innovative hospital where trust teamwork and technology come together to make a positive difference in the health of our community and region.
Where We Are:
Live where others only get to vacationHot Springs located in the gently rolling Ouachita Mountains offers a unique combination of natural beauty cultural life and historical interest. With numerous outdoor activities art galleries local shops and diverse cuisine Hot Springs has something for everyone.
Why Choose Us:
- Health (Medical Dental Vision) and 401K Benefits for full-time employees
- Competitive Paid Time Off / Extended Illness Bank package for full-time employees
- Short-term and Long-term disability 100% paid for by the company
- Employee Assistance Program mental physical and financial wellness assistance
- Loan repayment tuition reimbursement and scholarship opportunities for qualified candidates
- Professional development opportunities apprenticeship programs and certification assistance
- And much more
Position Summary:
The Referral Authorization Specialist is responsible for ensuring that patients are getting the care that they need in a timely manner on a daily basis this will involve processing referrals in a complete accurate and timely manner verifying that patients have received the care they require and notifying providers if patients do not follow through with include:
Completes pre-authorizations for all diagnostic testing therapy surgical and specialty care appointments according to insurance requirements within 3 days of issuance.
Notifies patient when referral is approved and notifies Provider if denied or if a second opinion or additional information is required.
Enters all communication with patient nurse and/or Provider will be documented in the clinic EMR.
Maintains up-to-date knowledge of all health care plans and interprets and communicates plan policies and procedures to employees physicians and (patients) when they have changed.
Identifies and attempts to resolve patients barriers to specialty care including assisting with scheduling appointments and helping to coordinate with specialist offices.
Other duties as assigned.
Minimum Qualifications:
- High school diploma or equivalent.
- Knowledge of insurance/medical terms and policies preferred but not required.
- Requires critical thinking skills decisive judgment and the ability to work with minimal supervision.
- Must be able to work in a stressful environment and take appropriate action.
- Familiarity with the use of Microsoft Office Suite; ability to utilize practice management EMR and Clockwise software accurately and efficiently.
- Professional appearance and manner.
EEOC Statement:
National Park Medical Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race color religion age sex national origin disability status genetics protected veteran status sexual orientation gender identity or expression or any other characteristic protected by federal state or local laws.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
