University Of Rochester Rochester , NY 14618
Posted 1 week ago
Opening
Full Time 40 hours URCA 205 Ortho Prior Authorization
Schedule
7 AM-5 PM
Responsibilities
POSITION SUMMARY:
The Referral & Prior Authorization Representative IV is a team leader responsible for supporting the surgeons, physicians, and advanced practice providers in their assigned division(s) in the departments of Orthopedic Surgery and Podiatry. Oversees and provides direction to lower-level team members, including serving as point of contact to answer questions and solve problems for difficult and unusual authorizations and referrals. Assists in problem identification, quantification and resolution. Trains new employees. Resolves problems and issues. Monitors quality assurance of daily operations. Provides coaching and training support.
TYPICAL DUTIES:
Operations 20%
Supports supervisors and managers in developing and executing staffing plans
Responsible for oversight of daily work for Referral & Prior Authorization Rep III in their assigned division(s)
Regularly monitors pending and/or outstanding authorizations and executes prompt action to ensure timely completion
May cover the duties of Referral & Prior Authorization Representative III on their team as needed for coverage and/or for complex and/or urgent authorizations
Operational Excellence 30%
Enforces guidelines for prioritizing and assigning work activities, monitors procedures to enhance levels of service and quality including monitoring in-basket messaging pools, work-queues and other tasks
Serves as a subject matter expert for their assigned division(s) maintaining an in- depth understanding of all workflows and processes
Preceptorship/Training 20%
Responsible for training new team members, re-education of existing team members
Serves as a resource for training staff on new processes and other go lives including implementation of new technology, etc.
Leadership 30%
Ensures effective and efficient communication amongst the Physicians and their support services teams as related to the scope of their role
Serves as an advisor to the physician, APPs, and other members of the support serves team as appropriate and related to the scope of their role
Provides feedback to supervisors and managers for performance reviews
QUALIFICATIONS:
High school diploma or equivalent required
Associate degree in medical, Secretarial, billing or related field preferred
Minimum of 1 year of medical office or clinical experience required
1-year experience working with insurance and prior authorization preferred
or equivalent combination of education and experience required
Demonstrated customer service skills required
Medical Terminology, experiences with surgical/appointment scheduling software and electronic medical records preferred
The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University's mission to Learn, Discover, Heal, Create - and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.
How To Apply
All applicants must apply online.
EOE Minorities/Females/Protected Veterans/Disabled
Pay Range
Pay Range: $19.91 - $26.88 Hourly
The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.
University Of Rochester