Job description
ABOUT AUSTIN REGIONAL CLINIC:
Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 10 years! We are one of central Texas’ largest professional medical groups with 25+ 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 Operations Manager, is responsible for obtaining authorizations and coordinating the care of patients that are referred to a specialist. May also be responsible for obtaining authorizations for medications. 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
- Maintains current knowledge of insurance authorization and/or referral requirements.
- Obtains authorizations from insurance carriers in a timely and efficient manner.
- Acts as a resource for patients and staff with authorization and/or referral related questions/problems requiring resolution.
- Communicates authorization and/or referral information to patients and specialist offices in a timely and efficient manner.
- Serves as a liaison between Primary Care and Specialty offices.
- Reviews chart to determine appropriate clinical to send to insurance as requested.
- Can create, modify and sign referral orders within protocols.
- Assists patients with scheduling appointments into specialty locations.
- Responsible for coordinating medical record information for transmission to specialist’s office.
- Ensures authorization and/or referral information is properly documented in Epic.
- If aware, informs physician of patient compliance with referral plan.
- Informs physicians and management of any issues causing a delay in authorization process.
- Communicates changes and important information
- Works efficiently with all departments to promote teamwork within the organization.
- Attends Authorization Meeting regularly, and participates on sub-committees as needed.
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.
AND
- Strong knowledge in business office functions and ability to serve as a resource to staff.
- Knowledge of medical insurance.
- Knowledge of medical terminology.
- Familiarity with procedural and diagnostic coding.
- Strong communication and interpersonal skills.
- Skill with operating PC and using the following software applications: MS Outlook, Word, Excel, and Microsoft Office OneNote.
- Excellent computer and keyboarding skills, including familiarity with Windows.
- Excellent verbal and written communication skills.
- Ability to provide excellent customer service.
- 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, flexible work hours of starting between 7 am- 9am. 8 hour work day. Work from home opportunity once orientation complete.
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