Reference Based Pricing Coordinator

(REMOTE)

RBP Coordinators shall be responsible for all phases of RBP operations, but shall be primarily focused on:

• Receiving and reviewing preauthorization’s for RBP plan members for prepricing.
• Coordinating with the UR Team to obtain any missing information regarding preauthorization.
• Accessing the prepricing portal and entering the preauthorization information to create a pre-claim.
• Creating the pre-estimate pricing letter from the pre-claim.
• Contacting facilities for appropriate fax numbers or to confirm billing form type.
• Faxing pre-estimate pricing letters with the preauthorization to facilities via the portal fax system.
• Receiving and reviewing all revised preauthorization’s with changes i.e., date of service, facility name/NPI, procedure codes etc. and updating information in pre-pricing portal.
• Sending all revised pre-estimate pricing letters to facilities via the portal fax system
• Maintaining the RBP worksheet with data entry of all received preauthorization’s and update with all actions taken.

• Excellent communication, written, telephonic and personal skills
• Ability to multitask
• Attention to detail
• Completion of all responsibilities in a timely manner
• Independent thinking
• Strong Organization Skills

• Proficient in computer technology including Microsoft Office Word, Excel and Teams
• Data Entry with excellent accuracy
• Medical Terminology preferred
• Team skills
• Strong communication skills