What are the responsibilities and job description for the Authorization & Referral Coordinator I position at External Brand?
ABOUT AUSTIN REGIONAL CLINIC:
Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years! We are one of central Texas’ largest professional medical groups with 35 locations and we are continuing to grow. We offer the following benefits to eligible team members: Medical, Dental, Vision, Flexible Spending Accounts, PTO, 401(k), EAP, Life Insurance, Long Term Disability, Tuition Reimbursement, Child Care Assistance, Health & Fitness, Sick Child Care Assistance, Development and more. For additional information visit https://www.austinregionalclinic.com/careers/.
PURPOSE
Under supervision of the Centralized Authorization and Referrals Supervisor, supports patient care in an inbound high volume call center environment seeking to provide a positive experience for each call. Answers incoming phone calls related to authorization and referrals and assists in the coordination of care for patients that are referred to a specialist and/or other services. Acts as a resource for patients and staff with authorization and/or referral related questions/problems requiring resolution. Carries out all duties while maintaining compliance, confidentiality, and promoting the mission and philosophy of the organization.
ESSENTIAL FUNCTIONS
· Answers incoming phone calls related to authorizations and referrals, adhering to schedule with assigned breaks and lunches.
· Maintains basic understanding of insurance authorization and/or referral requirements.
· Understands and communicates important authorization and/or referral information to patient and/or specialist in a timely manner.
· Responsible for coordinating medical record information for transmission to specialist’s office. · Responsible for creating authorization and referral requests as needed.
· Coordinates with Primary Care Offices and Specialty offices as needed.
· Works efficiently with all departments to promote teamwork within the organization.
· Attends Authorization & Referral Meeting regularly.
· Informs management of any issues causing a delay in process.
· Adheres to all company policies, including but not limited to, OSHA, HIPAA, compliance and Code of Conduct.
· Regular and dependable attendance.
· Follows the core competencies set forth by the Company, which are available for review on CMSweb.
OTHER DUTIES AND RESPONSIBILITIES
● Involvement in organizational development through meeting attendance and committee involvement.
● Responsibilities occasionally may require an adjusted work schedule, overtime, and evening/weekend hours in order to meet deadlines.
● Performs other duties as assigned.
QUALIFICATIONS
Education and Experience
Required: High school diploma or equivalent. Six (6) months or more experience working in the office of a healthcare related facility.
Preferred: Previous experience in insurance authorizations. Previous experience in a high volume customer service environment and/or experience with Avaya phone system a plus.
AND
Knowledge, Skills and Abilities
● Strong knowledge in business office functions and ability to serve as a resource to staff.
● Knowledge of medical insurance.
● Knowledge of medical terminology.
● Strong communication and interpersonal skills.
● Excellent computer and keyboarding skills, including familiarity with Windows and Adobe products.
● Excellent verbal and written communication skills.
● Ability to adhere to an assigned schedule with little deviation.
● Manual dexterity and sitting is required in carrying out position.
● Ability to provide excellent customer service.
● Ability to troubleshoot basic system issues.
● Ability to analyze problems, make decisions, and manage conflict.
● Ability to engage others, listen and adapt response to meet others’ needs.
● Ability to align own actions with those of other team members committed to common goals.
● Ability to manage competing priorities.
● Ability to perform job duties in a professional manner at all times.
● Ability to understand, recall, and communicate, factual information.
● Ability to understand, recall, and apply oral and/or written instructions or other information.
● Ability to organize thoughts and ideas into understandable terminology.
● Ability to apply common sense in performing job.
Work Schedule: Monday - Friday 8AM - 5PM. Remote Opportunity once in person training is completed.