Coordinator - Authorization and Referrals

Description

POSITION DESCRIPTION:

Responsible for obtaining timely and accurate authorizations for specialty referrals from managed care plans and insurance companies. Performs any duties related to referral activities, i.e.: schedules patient’s appointments, obtains authorizations, log’s authorizations, requires employee to exercise independent judgment. Adheres to Corporate Compliance program, by reporting improper or unethical conduct, violation of applicable laws, regulations or program requirements.

DETAILED DUTIES AND RESPONSIBILITIES:

• Obtains authorizations/pre-certification for specialty referrals.
• Enters data in management information system accurately and timely.
• Schedules patients’ appointments when necessary.
• Acts as liaison between hospital/providers and FHC as it relates to patient’s referrals and appointments.
• Maintains filing of pertinent paperwork.
• Prioritizes work duties and plans work schedule accordingly.
• Print referral letters from the computer to mail to patients.
• Courteously answers the telephone and directs calls appropriately.
• Answers routine questions regarding departmental operations, policies, and procedures.
• Demonstrates understanding of the Electronic Health Record and accuracy in all documentation there-in
• Performs assigned tasks as requested.
• Attends meetings and training seminars to enhance professional growth.

Requirements

KNOWLEDGE, SKILLS AND ABILITIES:

• Has working knowledge of all functions within Intergy including patient registration and cashiering.
• Clerical skills, such as typing, filing, spelling, grammar, arithmetic, and vocabulary.
• Ability to interpret and apply established departmental policies and procedures to a variety of work situations.
• Ability to establish and maintain effective working relationships with employees and medical community.
• Ability to exercise judgment and discretion.
• Communicates in a clear and concise manner, appropriate use and knowledge of medical terminology.
• Must be able to make good independent judgment.

TRAINING AND EXPERIENCE:

• High school diploma or equivalent training and experience.
• Two years experience in hospital and/or healthcare setting.

SPECIAL REQUIREMENTS:

• Bilingual skills English/Spanish preferred.