Provides excellent service to all customers, providers, and patients regardless of the complexity of the situations presented.
Analyzes the needs of patients and the ability of the Carle system to serve them.
Reviews and submits information required to complete pre-authorizations with insurance companies.
Contacts various clinics, facilities, companies to obtain information to accurately complete referral/pre authorization requests.
Utilizes third party payer/insurance portals; has a detailed knowledge of insurance providers, their portals and their expectations for authorization approval.
Advocates for patients in their navigation of the Carle system and outside clinics when Carle cannot provide the services needed.
Coordinates transmission of information back to Carle when patients are sent out of system for referrals.
Provides assistance with Carle Direct transfer services including: Answering incoming calls as available and transferring to the appropriate staff Confirming primary care providers prior to sending follow up information on transferred patients Confirming pending lab results with transferring labs on transferred patients Printing and mailing completed follow up information
The Carle Direct Access Specialist is responsible for the coordination, processing, and scheduling of medical referrals and prior authorizations for a variety of medical or diagnostic procedures for patients.
Carle Foundation Hospital