Referral & Prior Authorization Specialist - Saratoga Springs, United States - Saratoga Hospital

Saratoga Hospital
Saratoga Hospital
Verified Company
Saratoga Springs, United States

1 week ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
Description

Summary of Position:


Primary Job Responsibilities:

Processes all referrals and authorizations received. Completes prior authorizations and referrals as required for services and testing.

Collaborates with clinical team members, physician offices and agencies to ensure than an accurate and timely referral/authorization is processed and documented in accordance with department guidelines.

Manages and maintains the Electronic Referral Tracking Report for accuracy of information, urgency, and other designated criteria.


Acts as a resource to all internal and external customers, offering guidance and support for referral and authorization related questions and referral/authorization processing problems.

Ensures patients receive timely and courteous communications.

Informs referring providers when a requested service authorization request is denied.


Stays current with the insurance authorization requirements by utilizing the resource library of payor benefit-specific information and provider contact information.


Enters referrals and authorizations in to the system per standardized practice protocols and provides feedback to ordering provider and parent/patient in a timely manner.

Documents and provides updates in the patient's medical record, the status of the referral and/or authorization.

Communicates and provides feedback to providers and staff regarding changes, trends, and processes.


Minimum Qualifications:
High school graduate or GED. At least two years in a medical office or insurance company environment, experience with prior authorizations and referrals required. Medical terminology certificate preferred.


Salary Range:
$ $28.27

Pay Grade: 18

Compensation may vary based upon, but not limited to: overall experience and qualifications, shift, and location.

Location:
Saratoga Hospital - Patient Engagement Center


Schedule:
Full-Time, Day shift, 80
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