Referral & Medical Authorization Coordinator
Apply NowLocation:
US
Company:
OhioHealth is a nationally recognized healthcare system delivering world-class patient care with a focus on innovation and support for professional growth.
Summary:
The Referral & Medical Authorization Coordinator processes referral requests and ensures authorization numbers are obtained for healthcare services. Candidates must hold a High School diploma or GED and have prior relevant experience in healthcare pre-authorizations and knowledge of medical systems.
Requirements:
Credentials: High School or GED
Experience: Prior experience in obtaining healthcare pre-authorizations in Radiation Oncology, Experience in a physician practice or hospital setting with patient registration, front desk, and insurance knowledge required, Experience with third party payors required
Job Description:
Referral & Medical Authorization Coordinator
Job Description Summary:
This position is responsible for processing referral requests for all providers practicing within the clinic module and ensuring that when needed, referral/authorization numbers are obtained for these services. Access to specialty and ancillary testing services is a key component for the treatment of our patients and the satisfaction of our referring providers. The responsibilities of this position are extremely important in meeting or exceeding customer satisfaction.
Responsibilities And Duties:
- 40 % : Search electronic medical records to obtain the required clinical information needed for medical authorization. Provides all necessary information medical records, scripts, et c to payer.
- 30 % -Reviews, Obtains & Processes all diagnostic/specialty/miscellaneous referral and authorization requests for both provider and facility.
- 20 % Handles calls from internal and external sources where prioritization and time sensitive action is required.
- 10 % -Communicates with all involved, payer, provider, patient as appropriate and as per protocol. Provides a standard of excellence as it relates to customer service and satisfaction for all customers.
Minimum Qualifications:
High School or GED (Required)
Additional Job Description:
The ideal candidate should have the following:
- Prior experience in obtaining healthcare pre-authorizations in Radiation Oncology
- Working knowledge of ICD-10 and CPT classification systems
- Working knowledge of Anatomy & Physiology, and Medical Terminology
- Experience in a physician practice or hospital setting with patient registration, front desk, and insurance knowledge required
- Experience with third party payors required
- Detailed oriented, self-motivated, a continuous learner with an interest in process improvement, and team player
- Ability to navigate multiple computer screens and browsers quickly and accurately
- Strong communication skills & professional demeanor
- Able to learn and work in a remote work setting while maintaining departmental productivity and accuracy standards
Work Shift:
Day
Scheduled Weekly Hours :
40
Department
Corporate Pre Access
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities are subject to change. Other duties may be assigned as needed by leadership based on business need.
