Referral Authorization Specialist

Lifepoint Health • Sierra Vista, AZ

10h • Onsite

About The Position

Canyon Vista Medical Center is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Referral Authorization Specialist joining our team, you’re embracing a vital mission dedicated to making communities healthier ®. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.

Requirements

• High school diploma or equivalent required
• Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
• Must be able to work in a stressful environment and take appropriate action.

Nice To Haves

• Two years of college preferred

Responsibilities

• Ensures patients receive the care they need in a timely manner by processing referrals accurately and completely, verifying that patients receive the required care, and notifying providers when patients do not follow through with referrals.
• Completes pre-authorizations for all diagnostic testing, therapy, surgical, and specialty care appointments according to insurance requirements within three days of issuance.
• Notifies patients when referrals are approved and notifies providers when referrals are denied or when a second opinion or additional information is required. Documents all communication with patients, nurses, and/or providers in the clinic EMR.
• Updates referral information in the EMR following each communication with a patient, insurance provider, nurse, or provider.
• Maintains up-to-date knowledge of health care plans and interprets and communicates changes to plan policies and procedures to employees, physicians, and patients.
• Identifies and attempts to resolve barriers to specialty care, including assisting with appointment scheduling and coordinating with specialist offices.
• Assists with tracking high-priority referrals to ensure patients in high-risk categories receive necessary follow-up care.
• Under the supervision of a physician or nurse, assists with performing patient assessments and treatments.
• Performs administrative and clerical duties as assigned, including filing, reception, scheduling, data entry, and patient registration.
• Performs other duties as assigned.

Benefits

• Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
• Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
• Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
• Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
• Ongoing learning and career advancement opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED