What are the responsibilities and job description for the Referral & Authorization Specialist position at Western Reserve?
Function as a liaison between physicians and patients in the processes of obtaining authorizations for tests, diagnostic imaging, DME, and referrals to other providers. Is responsible for communication with patients, and processing referral in EMR. Also responsible for determining insurance eligibility and ensuring that all payor requirements are met for authorizations and insurance processing.
Education and Training
- High school diploma or equivalent required.
Experience
- Two (2) years of experience in medical insurance verification or other hospital finance areas required.
- Prior authorization experience required.
- Knowledge of authorization or referral verification requirements for Medicare, Medicaid, commercial insurance, managed care plans, workers compensation and other third-party payors required.