Prior Authorizations Specialist - Cardiology

Hartford HealthCare Medical Group•Trumbull, CT

5d•Onsite

About The Position

This role is responsible for obtaining authorizations for all testing appointments and insurance referrals. The specialist will check schedules weekly for new appointments, contact outside referring offices for authorization information, and obtain authorizations for outside scans such as CTA, CT, and MRI. The role also involves registering patients if needed, collaborating with Cardiology teams to ensure continuity of care, and assisting with the creation of standard work for insurance authorizations. Additionally, the specialist will respond to various requests and inquiries to coordinate patient appointments and needs, and contact patients, families, medical providers, and facilities to ensure smooth transitions of care into the Practice. Reviewing referring and transfer documents for accuracy and regulatory compliance is also a key responsibility.

Requirements

Minimum of 1 year as a medical receptionist or previous care coordination experience.
Direct customer service in the medical field.

Responsibilities

Obtaining authorizations on all testing appointments.
Obtaining Insurance Referrals.
Checking schedules weekly to make sure no new appointments have been added.
Contacting outside referring offices for authorization information on testing appointments.
Obtaining authorizations on outside referrals (e.g., CTA, CT, MRI, any outside scans).
Registering Patients if needed.
Collaborating and communicating with Cardiology teams to ensure continuity of medical care, including obtaining, clarifying, and validating referral requests.
Assisting with the creation of standard work for insurance authorizations.
Responding to all requests (email, website, phone, other) and inquiries to best coordinate a patient’s appointment and needs.
Contacting patients, families, medical providers and/or facilities to foster smooth transitions of care into the Practice.
Reviewing referring and transfer documents for accuracy and adherence to regulatory compliance and assuring the transitional care processes are implemented.