Authorization Referral Coordinator

DEFINITION/PRIMARY FUNCTIONS The Auth Referral Coordinator is a liaison for the Covid Call Center and Testing team. He/she is responsible for management of training and mentoring of new support staff, maintenance daily workflow oversight. The Auth Referral Coordinator functions clinically under the direction of the Central Scheduling manager and will perform other duties as requested. The Auth and Referral Coordinator will work collaboratively with other members of the team to ensure timely and smooth office flow, always keeping the needs of the patient first. The Auth/Referral Coordinator is responsible for selected fiscal aspects of scheduled/registered accounts to prepare account for billing, assuring maximum payment on a timely basis, and maintenance of accurate history files. The position is also responsible for daily review of selected scheduled/registered patients to assure a solid source of re-imbursement is in place. The position will obtain all authorizations to avoid insurance denials and assure timely and appropriate third-party reimbursement. They will handle inquiries and response of the appeals process. Responsible for all inquiries from patients, families, professional and institutional providers, inter and intra department staff, Government and third-party payers, case management companies, patient accounting, clinical department staff, and case managers until the time of billing. Acts as a patient advocate for patients with self-pay liabilities by informing them of hospital collection policy and referring them to the Advocacy for Access Office. POSITION QUALIFICATIONS (Minimum qualifications are required unless stated otherwise.) Experience: Minimum of three years# experience as a Medical Assistant in a preferred. Experience in handling multiple telephone lines and excellent clerical/organizational skills required. Medical terminology required. Expert knowledge of all major third-party payers, including Medicare, Medicaid, and Blue Cross required. In depth knowledge of Central Scheduling and registration modules. (preferred) Expert knowledge in COVID Testing/Vaccination scheduling and workflow. (preferred) Education and Training: High School diploma or equivalent required. Graduate of an accredited Medical Assistant program required. License, Certification

Registration:

CMA or RMA - Certified or Registered Medical Assistant CPR is required. Other Requirements: Experience in basic office skills. Working knowledge of Windows based PC applications required. Experience in surgical scheduling, procedures, etc. preferred. Ability to work independently and take direction. Demonstrated ability to read and follow written/verbal direction. Sensitive to diverse cultures and cultural differences. Knowledge of community services. Demonstrated ability to adapt to fast-paced, multifaceted position. Good telephone communication skills. Must be flexible to cover for needs of department. Flexible hours required. Self-motivated and ability to be independent and flexible within a team framework. Excellent oral and written communication skills. Demonstrated ability to handle confidential and sensitive information. Must be able to speak and write the English language in an understandable manner. Must be willing to accept #on-call# responsibilities.

• DEFINITION/PRIMARY FUNCTIONS

• The Auth Referral Coordinator is a liaison for the Covid Call Center and Testing team. He/she is responsible for management of training and mentoring of new support staff, maintenance daily workflow oversight. The Auth Referral Coordinator functions clinically under the direction of the Central Scheduling manager and will perform other duties as requested. The Auth and Referral Coordinator will work collaboratively with other members of the team to ensure timely and smooth office flow, always keeping the needs of the patient first. The Auth/Referral Coordinator is responsible for selected fiscal aspects of scheduled/registered accounts to prepare account for billing, assuring maximum payment on a timely basis, and maintenance of accurate history files. The position is also responsible for daily review of selected scheduled/registered patients to assure a solid source of re-imbursement is in place. The position will obtain all authorizations to avoid insurance denials and assure timely and appropriate third-party reimbursement. They will handle inquiries and response of the appeals process. Responsible for all inquiries from patients, families, professional and institutional providers, inter and intra department staff, Government and third-party payers, case management companies, patient accounting, clinical department staff, and case managers until the time of billing. Acts as a patient advocate for patients with self-pay liabilities by informing them of hospital collection policy and referring them to the Advocacy for Access Office.

• POSITION QUALIFICATIONS (Minimum qualifications are required unless stated otherwise.)

• Experience:

• Minimum of three years' experience as a Medical Assistant in a preferred.

• Experience in handling multiple telephone lines and excellent clerical/organizational skills required.

• Medical terminology required.

• Expert knowledge of all major third-party payers, including Medicare, Medicaid, and Blue Cross required.

• In depth knowledge of Central Scheduling and registration modules. (preferred)

• Expert knowledge in COVID Testing/Vaccination scheduling and workflow. (preferred)

• Education and Training:

• High School diploma or equivalent required.

• Graduate of an accredited Medical Assistant program required.

• License, Certification & Registration:

• CMA or RMA - Certified or Registered Medical Assistant

• CPR is required.

• Other Requirements:

• Experience in basic office skills.

• Working knowledge of Windows based PC applications required.

• Experience in surgical scheduling, procedures, etc. preferred.

• Ability to work independently and take direction.

• Demonstrated ability to read and follow written/verbal direction.

• Sensitive to diverse cultures and cultural differences.

• Knowledge of community services.

• Demonstrated ability to adapt to fast-paced, multifaceted position.

• Good telephone communication skills.

• Must be flexible to cover for needs of department.

• Flexible hours required.

• Self-motivated and ability to be independent and flexible within a team framework.

• Excellent oral and written communication skills.

• Demonstrated ability to handle confidential and sensitive information.

• Must be able to speak and write the English language in an understandable manner.

• Must be willing to accept "on-call" responsibilities.