Referral/Pre Auth Coordinator

North Kansas City Hospital•North Kansas City, MO

70d

About The Position

Here at NKC Health our mission is to empower hope and healing in every life we touch. Whether you are serving patients at a primary care clinic, specialty clinic, or in a support capacity, every team member works together to complete this mission. NKC Health Neurosurgery clinic is hiring a Referral/Pre-Authorization Coordinator! If you're looking for a great opportunity to impact our communities, join our NKC Health team! Why NKC Health Medical Group? Comprehensive Benefits (Medical, Dental, Vision, Life, FSA) Employer matched retirement plan Competitive wages Paid time off for personal/vacation/sick Six paid holidays per year Educational assistance Day shift schedules What does a Referral/Pre-Authorization Coordinator do? Under the direction of the Practice Manager or Supervisor, Patient Services, this position is responsible for coordinating and ensuring referrals and/or pre-authorizations are managed and addressed appropriately. Works collaboratively with the health care team and the patient to schedule referral appointments, and independently completes the process for required pre-certification and prior authorizations in a timely manner. What does a typical day on the job look like?

Requirements

High school graduate or GED
Minimum two years of experience in a physician office preferred.
Working knowledge of medical terminology and knowledge of various insurance company requirements for pre-certification and referrals.
Basic office skills, critical thinking, detail oriented and able to multitask in a fast paced environment.

Responsibilities

Provides quality service by acting as a liaison between healthcare team, patient and specialists to coordinate outpatient referrals and obtain pre-certifications or prior authorizations as necessary.
Utilizes the EMR system to its full potential in capturing the necessary information needed for making an appointment and communicating necessary information such as referral requirements, patient demographic information, insurance and approval information, and comments about specific patient information key to a successful appointment.
Provides education to patients about the importance of the referral process and service provided by the physician's office, which may include subspecialty focus.
Coordinates efforts between providers, gathering and providing information key to appointment success.
Communicates to physicians and other health care providers the various requirements and processes involved with medical referral authorizations for the most expedient patient appointment and successful visit.
Completes the referral and/or preauthorization process by ensuring the specialists' report or test results are received.
Notifies the referring physician when a patient does not keep a referral appointment or a pre-authorization is denied.
Monitors incoming patient paperwork to be scanned and flags results that are to be reviewed by the physician.
Completes FMLA, ADA and other medical paperwork as directed by the physician.