Referral Authorization Specialist

Lifepoint Health • Hot Springs, AR

9h • Onsite

About The Position

The Referral Authorization Specialist is responsible for ensuring that patients are getting the care that they need in a timely manner. On a daily basis, this will involve processing referrals in a complete, accurate, and timely manner, verifying that patients have received the care they require, and notifying providers if patients do not follow through with referrals.

Requirements

• High school diploma or equivalent.
• 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.
• Familiarity with the use of Microsoft Office Suite; ability to utilize practice management, EMR, and Clockwise software accurately and efficiently.
• Professional appearance and manner.

Nice To Haves

• Knowledge of insurance/medical terms and policies preferred but not required.

Responsibilities

• Completes pre-authorizations for all diagnostic testing, therapy, surgical and specialty care appointments according to insurance requirements within 3 days of issuance.
• Notifies patient when referral is approved and notifies Provider if denied or if a second opinion or additional information is required.
• Enters all communication with patient, nurse, and/or Provider will be documented in the clinic EMR.
• Maintains up-to-date knowledge of all health care plans and interprets and communicates plan policies and procedures to employees, physicians and (patients) when they have changed.
• Identifies and attempts to resolve patient’s barriers to specialty care, including assisting with scheduling appointments and helping to coordinate with specialist offices.
• Other duties as assigned.

Benefits

• Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
• Competitive Paid Time Off / Extended Illness Bank package for full-time employees
• Short-term and Long-term disability 100% paid for by the company
• Employee Assistance Program – mental, physical, and financial wellness assistance
• Loan repayment, tuition reimbursement and scholarship opportunities for qualified candidates
• Professional development opportunities, apprenticeship programs, and certification assistance

What This Job Offers

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