Referral & Medical Authorization Coordinator

OhioHealth • Williamstown, KY

6d

About The Position

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more – in our careers and in our communities. Job Description Summary This position is responsible for processing referral requests for all providers practicing within the clinic module and ensuring that when needed, referral/authorization numbers are obtained for these services. Access to specialty and ancillary testing services is a key component for the treatment of our patients and the satisfaction of our referring providers. The responsibilities of this position are extremely important in meeting or exceeding customer satisfaction.

Requirements

• High School or GED (Required)
• BLS - Basic Life Support - American Heart Association
• Excellent customer service and organizational skills, ability to communicate effectively, both written and orally, strong typing and computer skills with the ability to multi task in a fast paced environment.
• Working knowledge of ICD-9 and CPT-4 classification systems, Anatomy & Physiology, Medical Terminology, inpatient and outpatient services.
• 1-2 years working knowledge while obtaining referral, medical authorizations in a healthcare facility interacting regularly with insurance representative, physician office or patient via telephone.
• Minimum of 2 years Experience in a physician office with extensive patient registration, front desk and insurance Experience and knowledge required.
• One years Experience with third party payors required.
• Computer Experience required.

Responsibilities

• Search electronic medical records to obtain the required clinical information needed for medical authorization. Provides all necessary information medical records, scripts, et c to payer.
• Reviews, Obtains & Processes all diagnostic/specialty/miscellaneous referral and authorization requests for both provider and facility.
• Handles calls from internal and external sources where prioritization and time sensitive action is required.
• Communicates with all involved, payer, provider, patient as appropriate and as per protocol. Provides a standard of excellence as it relates to customer service and satisfaction for all customers.

What This Job Offers

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