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: 8:30am to 4:30pm, Mon-FriPay: $16.80/hour DOE, with bilingual differential Referral & Prior Authorization Rep Responsibilities:
Research and correct invalid or incorrect patient demographic insurance information such as phone numbers or insurance policy specifics
Verify insurance or self-pay information
Maintain current electronic listings of in-network specialty providers, and update on a daily basis
Communicate and work with providers, nurses, and other staff to settle unresolved referrals
Respond professionally to all inquiries from patients, staff, and payers
Accurately document actions taken on a patient record in a timely fashion
Maintain and follow through on all referrals and prior authorizations within designated timeframe
Referral & Prior Authorization Rep Requirements:
High school diploma or equivalent
Demonstrate computer software skills and aptitude with MS Office and medical billing software
Demonstrate overall understanding of medical billing, medical terminology, insurance claims and authorization processing
Ability to prioritize, follow through and assume responsibility and use good judgment
Communicate effectively with patients, external companies and providers both orally and in writing
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 to contact Courtney or Caitlyn at 815-229-7810. #FSC
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