Outpatient Referral & Authorization Representative-8111
On-site · Kingman, Arizona, United States
Job Summary
Outpatient Referrals & Authorizations Representative responsibilities include financially clearing outpatient referrals, verifying insurance eligibility and benefits, contacting patients to discuss coverage, initiating authorizations when necessary, and documenting communications in the referral and EMR system. The role requires handling referrals and authorizations within established timelines, maintaining payer statistics, conveying information to the scheduling center and supervisors, and assisting with education for Outpatient Scheduling Reps. Lead responsibilities add supervision of team members, QA audits, staff hiring input, process-improvement initiatives, and collaboration with management to ensure day-to-day operations.
Required Qualifications
- Education: High school graduate/GED or 2-5 years healthcare experience in lieu of education requirement
- Six months or more of progressive work experience
- Ability to communicate effectively with others
- Manage multiple priorities and tasks
- Maintain attention to detail
- Knowledge of and ability to use computer hardware and software applications
- Preferences: One-year hospital outpatient referrals and/or insurance verification experience preferred
- Knowledge of medical terminology, coding rules and guidelines preferred
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