Referral/Authorization Coordinator

Illinois Bone and Joint Institute LLC • Bourbonnais, IL

78d

About The Position

OAK Orthopedics is currently looking for a full-time Referral/Authorization Coordinator for our Bourbonnais location. The Referral/Authorization Coordinator is responsible for facilitating the administration of requested medical services for appropriate utilization of resources. This is accomplished by evaluating referral requests for eligibility, benefit determination, preferred provider networks, level of care and authorization of referral requests.

Requirements

• Two year experience in the medical or health insurance field.
• One year previous referral and/or precertification experience in an office or health plan setting are preferred.
• Ability to communicate effectively, both written and orally.
• Ability to multitask in a fast paced environment.
• Able to work independently.
• Typing skills.
• CPT and ICD-9 coding familiarity.
• Knowledge of Microsoft Office (Word, PowerPoint).

Responsibilities

• Authorizing referrals and applying criteria (where necessary).
• Meets or exceeds Departmental productivity targets on a weekly basis.
• Maintains files and records of referral/authorization activity.
• Demonstrates initiative, motivation and resourcefulness in day-to-day operations.
• Demonstrates the ability to utilize medical necessity criteria, scope of benefits and health plan criteria.
• Works aggressively with physicians and physician office staff to obtain necessary authorization related to referral requests.
• Assists with cross coverage within the referral/authorization team as assigned.
• Participates in staff meetings.
• Maintains professional and positive interaction with physicians, offices, members and health plan staff.
• Effectively and efficiently uses time and resources to achieve work related goals.
• Takes responsibility for assigned work, following through to ensure goals are met or exceeded.
• Demonstrates openness to new ideas and ways of working.
• Works cooperatively and collaboratively with others.
• Performs other duties as assigned by the manager.

What This Job Offers

• Job Type: Full-time
• Number of Employees: 1,001-5,000 employees