3 Referral/Authorization Specialist - (Remote) Jobs in Columbus, OH
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Referral/Authorization Specialist - (Remote)
$38k-46k (estimate)
Full Time
3 Weeks Ago
Morgan Stephens is Hiring a Remote Referral/Authorization Specialist - (Remote)
Job Title: Referral / Authorization Specialist
(Healthcare Experience REQUIRED)Location: Must live on East Coast - Eastern Time Zone
Pay: $24.00 per hour and up
Work Arrangement: 100% Remote
Experience Required: 1 Years of Relevant Experience
Company Overview:Our organization is committed to enhancing the healthcare journey for our members. We are dedicated to delivering accessible, high-quality care tailored to the unique needs of our communities. As a Referral / Authorization Specialist, you will play a crucial role in ensuring our members promptly receive the services they require.
Summary: We are seeking a highly organized and detail-oriented individual to join our team. The ideal candidate will possess extensive knowledge of prior authorization and referrals processes, medical terminology, and ICD-10 coding. The primary responsibilities include processing faxes, building authorizations, and effectively communicating with healthcare providers. This role requires a strong understanding of medical billing codes, computer literacy, and the ability to ensure compliance with State and Federal healthcare regulations.
Essential Functions:
(Healthcare Experience REQUIRED)Location: Must live on East Coast - Eastern Time Zone
Pay: $24.00 per hour and up
Work Arrangement: 100% Remote
Experience Required: 1 Years of Relevant Experience
Company Overview:Our organization is committed to enhancing the healthcare journey for our members. We are dedicated to delivering accessible, high-quality care tailored to the unique needs of our communities. As a Referral / Authorization Specialist, you will play a crucial role in ensuring our members promptly receive the services they require.
Summary: We are seeking a highly organized and detail-oriented individual to join our team. The ideal candidate will possess extensive knowledge of prior authorization and referrals processes, medical terminology, and ICD-10 coding. The primary responsibilities include processing faxes, building authorizations, and effectively communicating with healthcare providers. This role requires a strong understanding of medical billing codes, computer literacy, and the ability to ensure compliance with State and Federal healthcare regulations.
Essential Functions:
- Authorization Processing:
- Provide accurate and efficient computer entries for authorization requests and provider inquiries through phone, mail, or fax.
- Verify member eligibility and benefits to facilitate appropriate authorization procedures.
- Determine provider contracting status and ensure appropriateness for the requested services.
- Assess diagnosis and treatment requests, assigning appropriate billing codes (ICD-10 and/or CPT/HCPC codes).
- Verify coordination of benefits (COB) status for members.
- Inpatient Hospitalization Oversight:
- Verify and maintain inpatient hospital census, including admissions and discharges.
- Coordinate with healthcare providers to ensure timely and accurate information exchange.
- Communication and Triage:
- Communicate with healthcare providers, both verbally and in writing, to gather necessary information and address inquiries.
- Triage members and information to the appropriate Health Care Services staff, ensuring seamless workflow.
- Data Entry and Database Management:
- Enter relevant data into systems accurately and promptly.
- Maintain up-to-date and comprehensive records of authorizations and related information.
- Eligibility and Benefits Verification:
- Check eligibility for members requiring hospitalization or utilization review for other healthcare services.
- Verify and communicate benefits information to relevant stakeholders.
- Proficiency in medical terminology, ICD-10 coding, and prior authorization processes.
- Strong computer literacy and experience with healthcare databases.
- Excellent organizational and multitasking skills.
- Effective communication skills, both written and verbal.
- Detail-oriented with a commitment to accuracy.
- Ability to work collaboratively in a team-oriented environment.
- High school diploma or equivalent; Bachelor's degree in a related field is a plus.
- Previous experience in health care services coordination or a related role.
- Familiarity with State and Federal healthcare regulations.
- Education: High school diploma or equivalent. Additional college coursework in healthcare administration or related fields is advantageous.
- Experience: 1 year of experience in referral and authorization coordination within the healthcare or managed care sector.
- Technical Proficiency: Proficient in using computer systems and software, particularly Microsoft Office and relevant healthcare management applications.
- Communication Skills: Strong verbal and written communication skills, with the ability to interact professionally with providers and internal teams.
- Organizational Aptitude: Excellent organizational and time-management skills for managing multiple referrals and authorizations simultaneously.
- Attention to Detail: A keen eye for detail is essential to ensure the accuracy of referral and authorization processes.
- Problem-Solving: Effective problem-solving skills to address issues and discrepancies.
- Adaptability: Ability to adapt to changes in policies and procedures.
- Team Player: Collaborative and willing to work as part of a team to achieve shared objectives.
Job Summary
JOB TYPE
Full Time
SALARY
$38k-46k (estimate)
POST DATE
05/16/2024
EXPIRATION DATE
07/10/2024
WEBSITE
morganstephens.com
HEADQUARTERS
TALLAHASSEE, FL
SIZE
<25
FOUNDED
2014
CEO
JOSEPH TOLLAND
REVENUE
<$5M
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