Referral & Prior Authorization Representative
We have a Furst-to-hire opportunity for a Referral & Prior Authorization Rep at a regional medical clinic. The client prefers the Referral & Prior Authorization Rep be bilingual in Spanish as they will deal with many Spanish-speaking patients. The Referral & Prior Authorization Rep will be responsible for verifying and obtaining authorizations for specialty services, and for setting appointments on behalf of patients. The Referral & Prior Authorization Rep will act as a liaison between the patient, organization, and external customers.
Hours: 8am to 4:30pm, Mon-Fri
Pay: $16.75/hour
Referral & Prior Authorization Rep Responsibilities:
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Research and correct invalid or incorrect patient demographic insurance information such as phone numbers or insurance policy specifics
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Verify insurance or self-pay information
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Maintain current electronic listings of in-network specialty providers, and update on a daily basis
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Communicate and work with providers, nurses, and other staff to settle unresolved referrals
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Respond professionally to all inquiries from patients, staff, and payers
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Accurately document actions taken on a patient record in a timely fashion
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Maintain and follow through on all referrals and prior authorizations within designated timeframe
Referral & Prior Authorization Rep Requirements:
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High school diploma or equivalent & MUST have a valid Driver's License
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Demonstrate computer software skills and aptitude with MS Office and medical billing software
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Demonstrate overall understanding of medical billing, medical terminology, insurance claims and authorization processing
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Ability to prioritize, follow through and assume responsibility and use good judgment
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Communicate effectively with patients, external companies and providers both orally and in writing
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Five years’ experience in medical billing, referrals, or prior authorizations.
The Referral & Prior Authorization Rep is a detail-oriented position requiring the ability to work well with minimum to no supervision. Please apply here or contact Courtney or Denessa at 815-229-
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