Referral & Authorization Coordinator

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    "requisitionDescription": "<div><div><div><div><div><div><div><div><div><link href=\"https://static.workforcenow.adp.com/mas/mdf-components/23.18.17/styles/froala_editor.pkgd.min.css\" rel=\"stylesheet\" type=\"text/css\"><div><link href=\"https://static.workforcenow.adp.com/mas/mdf-components/23.18.17/styles/froala_editor.pkgd.min.css\" rel=\"stylesheet\" type=\"text/css\">&nbsp;<link href=\"https://static.workforcenow.adp.com/mas/mdf-components/23.18.17/styles/froala_style.min.css\" rel=\"stylesheet\" type=\"text/css\"><div class=\"fr-view\"><p><span style=\"color: rgb(32, 33, 36); font-family: Roboto, arial, sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: pre-line; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;\" id=\"isPasted\">We are looking for a energetic, hard-working, dependable, multi-tasking Medical Insurance Authorization specialists who are passionate about helping others and making a difference.&nbsp;</span></p><p><strong><span style='font-size:15px;font-family:\"Calibri Light\",sans-serif;color:#262321;'>DUTIES AND RESPONSIBILITIES: <em>&nbsp;&nbsp;</em></span></strong></p><ul type=\"disc\" style=\"margin-bottom:0in;\"><li id=\"isPasted\">Verifies information provided by referring physicians and verifies insurance coverage.&nbsp;<ul type=\"circle\"><li>Analyze patient records and insurance policies to determine if procedures, treatments, or medications require prior authorization</li><li>Ensure patients are eligible for services and that insurance benefits are accurate&nbsp;</li><li>Interacts with healthcare providers, insurance companies, and patients to obtain and provide information needed for authorization decisions</li><li>Notify providers of potential coverage options</li><li>Communicate with patients about the authorization process and any potential delays or financial implications.&nbsp;</li><li>May suggest formulary/cheaper alternatives for expensive drugs.&nbsp;</li><li>May investigate any serious drug interactions with the requested drug. &nbsp;</li></ul></li></ul><ul type=\"disc\" id=\"isPasted\"><li id=\"isPasted\">Completes authorizations and referrals for our medical services, including appointments and procedures.&nbsp;<ul type=\"circle\"><li>Input new patient information and update information in our system</li><li>Compile and submit detailed authorization requests to insurance companies, including all necessary documentation</li><li>Research and resolve any issues or discrepancies related to authorization requests</li><li>Monitor and follow up on authorization requests to ensure timely processing</li><li>Investigate insurance denials and resubmit requests or appeal when necessary.&nbsp;</li><li>Complete billing documentation</li></ul></li><li>Monitors the schedule for add-on patients, ensuring no conflicts, and we have required prior authorization to move forward with appointment or procedure.</li><li>Remain informed about healthcare industry regulations, trends and insurance policies</li><li>Assist with other clerical tasks as needed and perform other related duties as assigned by management. &nbsp;</li></ul><p style='margin-right:0in;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;margin-top:0in;margin-bottom:8.0pt;font-size:11.0pt;background:white;'><br></p><p style='margin-right:0in;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;margin-top:0in;margin-bottom:8.0pt;font-size:11.0pt;background:white;' id=\"isPasted\"><strong><span style='font-size:15px;font-family:\"Calibri Light\",sans-serif;color:#262321;'>QUALIFICATIONS: &nbsp;</span></strong></p><ul style=\"list-style-type: disc;\"><li><span style='font-family:\"Calibri Light\",sans-serif;color:#262321;'>High school diploma or general education degree (GED), or one to three months related experience and/or training, or equivalent combination of education and experience. &nbsp; Associate degree a plus.&nbsp;</span></li><li><span style='font-family:\"Calibri Light\",sans-serif;color:#262321;'>Some experience in medical billing or insurance authorization (strongly preferred).</span></li><li><span style='font-family:\"Calibri Light\",sans-serif;color:#262321;'>Knowledge of medical terminology.</span></li><li><span style='font-family:\"Calibri Light\",sans-serif;color:#262321;'>Basic computer skills.</span></li><li><span style='font-family:\"Calibri Light\",sans-serif;color:#262321;'>Attention to detail.</span></li></ul><p>JOB TYPE / WORK SCHEDULE:</p><ul><li>This is a full-time position, in-office position</li><li>Standard office hours, Monday - Friday 8:00 AM - 4:30 PM</li><li>Bilingual Required</li></ul><p style='margin:0in;font-size:16px;font-family:\"Aptos\",sans-serif;' data-pasted=\"true\">Competitive pay and full benefits package, including 401(k), health, dental, vision, life, and disability insurance.</p></div></div></div></div></div></div></div></div></div></div></div>\n",
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