What are the responsibilities and job description for the Referral/Pre-Auth Specialist - Rehab Therapy position at PeaceHealth?
Description
Job Description
PeaceHealth is seeking a Referral/Pre-Auth Specialist - Rehab Therapy for a Full Time, 1.00 FTE, Day position.
The salary range for this job opening at PeaceHealth is $25.78 – $34.80.
The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.
Job Summary
Responsible for receiving, processing and documenting referral or prior authorization requests from the clinical areas. Provides customer service and support for the clinical areas and patients for referrals and prior authorizations.
Details of the Position:
Lifting
See how PeaceHealth is committed to
For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.
Job Description
PeaceHealth is seeking a Referral/Pre-Auth Specialist - Rehab Therapy for a Full Time, 1.00 FTE, Day position.
The salary range for this job opening at PeaceHealth is $25.78 – $34.80.
The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.
Job Summary
Responsible for receiving, processing and documenting referral or prior authorization requests from the clinical areas. Provides customer service and support for the clinical areas and patients for referrals and prior authorizations.
Details of the Position:
- Oversees the data entry and completion of referral forms/notifications. Obtains insurance pre-authorization for patients and re-authorization of additional treatment. Ensures insurance carrier documentation requirements are met and referral support documentation is filed in patient’s medical record.
- Efficiently manages correspondence with patients, physicians, specialists, and insurance companies. Documents pertinent information on referral form and/or in medical record. Ensures practitioners are following standardized guidelines as recommended by evidenced based medicine.
- Works in collaboration with Patient Financial Services to improve the Revenue Cycle process. Continually improve work process to enhance service and customer relations.
- Works to improve Managed Care processes, communication, and patient care as it relates to Managed Care. Keeps up with continual changes in the health insurance Managed Care arena and communicates those changes as appropriate.
- Performs other duties as assigned.
- Accredited School Preferred: Business or two years college in related field
- Minimum of 3 years Required: Experience working in insurance in a medical related field or other related experience and
- Required: Demonstrated experience in insurance requirements for referrals and/or prior authorizations to various therapies, surgeries, procedures, diagnostic testing, etc
- Preferred: Medical Assistant, LPN, or RN
- Proficient computer skills including MS Office applications. (Required)
- Good communication skills, both verbal and written. (Required)
Lifting
- Consistently operates computer and other office equipment.
- Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.
- Sedentary work.
- Predominantly operates in an office environment.
- Ability to communicate and exchange accurate information.
- The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.
See how PeaceHealth is committed to
For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.
Salary : $26 - $35