Insurance Authorization/Referral Coordinator

Singing River Health System•Gulfport, MS

4d•Onsite

About The Position

The Authorization Specialist evaluates medical services ordered for authorization requirements with payers and obtains authorization for diagnostic imaging, radiation therapy, oncology, rheumatology, and other services when necessary for reimbursement. Expectation is for all performed duties to be in accordance with Singing River Health System procedures and policies, accreditation organization, and governing guidance and publications for health care employees.

Requirements

High School diploma or equivalent required.
Must have de-escalation training completed by the end of position orientation (90 days); must have appropriate level of de-escalation training.
Experience in a hospital or physician office setting obtaining authorizations for diagnostic imaging services or medical oncology services preferred.
Must demonstrate keen mental faculties/assessment and decision making abilities.
Must demonstrate superior communication/speaking/enunciation skills to receive and give information in person and by telephone.
Must demonstrate strong written and verbal communication skills.
Must possess emotional stability conducive to dealing with high stress levels.
Must demonstrate ability to work under pressure and meet deadlines.
Attention to detail and the ability to multi-task in complex situations is required.
Must have the ability to maintain collaborative and respectable working relationships throughout SRHS and other organizations.
Must possess superior customer service skills and professional etiquette.
Must possess proficient knowledge and ability to use a computer (must be keyboard proficient) and other office technology (i.e., telephone, fax, etc.).
Must have working knowledge of MS Outlook, Word, Excel, and PowerPoint.
Work requires the ability to function independently, adapt to workload demands, set priorities, and understand and set goals.
Must understand the fundamentals of automated data processing, and be able to quickly gain a detailed understanding of complex computerized and non-computerized information.
Must possess knowledge of medical, coding, and billing terminology.
Must have an understanding of Revenue Cycle functions in a hospital setting and thorough knowledge of state and federal laws, as they apply.
Must be able to navigate within an Electronic Medical Record (EMR).

Nice To Haves

Associates or bachelor’s degree in business finance, healthcare administration, or related field preferred.
Certification as a Prior Authorization Certified Specialist through the National Board of Prior Authorization Specialists preferred.

Responsibilities

Evaluates medical services ordered for authorization requirements with payers.
Obtains authorization for diagnostic imaging, radiation therapy, oncology, rheumatology, and other services when necessary for reimbursement.
Perform duties in accordance with Singing River Health System procedures and policies, accreditation organization, and governing guidance and publications for health care employees.
Complete de-escalation training by the end of position orientation (90 days).
Possess superior customer service skills and professional etiquette.
Proficiently use a computer (keyboard proficient) and other office technology (i.e., telephone, fax, etc.).
Work with MS Outlook, Word, Excel, and PowerPoint.
Function independently, adapt to workload demands, set priorities, and understand and set goals.
Understand the fundamentals of automated data processing, and be able to quickly gain a detailed understanding of complex computerized and non-computerized information.
Possess knowledge of medical, coding, and billing terminology.
Understand the fundamentals of Revenue Cycle functions in a hospital setting and thorough knowledge of state and federal laws, as they apply.
Navigate within an Electronic Medical Record (EMR).