Centralized Authorization & Referral Manager

External Brand•Austin, TX

53d

About The Position

Under general supervision of the Associate Director of Centralized Operations, the Centralized Authorization and Referral Manager supports patient care by ensuring the timely and adequately processing of referrals and authorizations. Institutes changes and updates workflows as necessary as a response to insurance, healthcare, and organizational changes. Duties also include but are not limited to hiring, coaching, motivating, staffing, evaluating, and training staff. Carries out all duties while maintaining compliance and confidentiality and promoting the mission and philosophy of the organization.

Requirements

At least four (4) or more years of supervisory experience
Previous experience in insurance authorizations
Bachelor’s degree in healthcare administration, Business, or related field with two (2) or more years of experience in a clinic or similar healthcare related setting OR High school diploma or equivalent with four (4) or more years of experience in a clinic or similar healthcare related setting.
Strong knowledge in business office functions and ability to serve as a resource to staff.
Knowledge of medical insurance and authorization requirements.
Knowledge of medical terminology.
Strong communication and interpersonal skills.
Excellent computer and keyboarding skills, including familiarity with Windows.
Excellent verbal and written communication skills.
Skill with operating PC and using the following software applications: MS Outlook, Word, Excel, and Microsoft Office OneNote.
Ability to provide excellent customer service.
Ability to analyze problems, make decisions, and manage conflict.
Ability to engage others, listen and adapt response to meet others’ needs.
Ability to align own actions with those of other team members committed to common goals.
Ability to manage competing priorities.
Ability to perform job duties in a professional manner at all times.
Ability to understand, recall, and communicate, factual information.
Ability to understand, recall, and apply oral and/or written instructions or other information.
Ability to organize thoughts and ideas into understandable terminology.
Ability to apply common sense in performing job.

Responsibilities

Supports patient care by ensuring the timely and adequately processing of referrals and authorizations.
Institutes changes and updates workflows as necessary as a response to insurance, healthcare, and organizational changes.
Supervises authorization and referral staff.
Ensures adequate staffing.
In collaboration with resource departments, responsibilities include hiring, motivating, evaluating, disciplinary actions, staff training and development, promoting teamwork and fostering a positive work environment.
Keeps up to date with insurance and referral requirements.
Ensures teams are adhering to departmental guidelines and operational expectations.
Updates and maintains reporting for department.
Serves as an escalation point for staff to resolve service, patient and referral process concerns. Assists in resolution for issues.
Implements improvements to departmental workflows and processes.
Builds resources and team materials.
Ensures compliance with ARC standards as well as applicable federal, state, and local laws.
Meets staffing requirements as determined by the management team, in a manner that effectively and efficiently meets the needs of the organization.
Builds communication and teamwork by holding regularly scheduled meetings with Supervisors and/or Team Leaders.
Coordinates with Supervisor and Human Resources to ensure proper counseling or discipline documentation occurs, as appropriate.
Reviews reports on productivity and quality with Supervisors and/or Team Leaders.
Collaboratively works between operations and clinic management.
Assists with development and/or implementation of department-specific policies, procedures, and programs and monitors adherence to system-wide policies/standardizations.
Attends administrative and executive meetings as necessary to deliver reports and updates regarding the CART team.
Assists with coverage, training, scheduling, and overall responsibilities as it pertains for Holiday shifts.
Serves and actively participates on various committees or meetings as a voice for the department.
Promotes long term financial stability and sustainable growth to safeguard our ability to continue to offer high quality, coordinated care.
Adheres to all company policies, including but not limited to, OSHA, HIPAA, compliance and Code of Conduct.
Regular and dependable attendance.
Follows the core competencies set forth by the Company, which are available for review on ARC Sharepoint.
Attends system meetings as invited.
Involvement in organizational development through meeting attendance and committee involvement.
Responsibilities occasionally may require an adjusted work schedule and evening/weekend hours in order to meet deadlines.
Performs other duties as assigned.