Centralized Authorization & Referral Manager en Austin Regional Clinic

ABOUT AUSTIN REGIONAL CLINIC:

Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years!   We are one of central Texas’ largest professional medical groups with 35+ 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 general supervision of the Associate Director of Centralized Operations, the Centralized Authorization and Referral Manager supports patient care by ensuring the timely and adequately processing of referrals and authorizations. Institutes changes and updates workflows as necessary as a response to insurance, healthcare, and organizational changes. Duties also include but are not limited to hiring, coaching, motivating, staffing, evaluating, and training staff. Carries out all duties while maintaining compliance and confidentiality and promoting the mission and philosophy of the organization.

 ESSENTIAL FUNCTIONS

• Supports patient care by ensuring the timely and adequately processing of referrals and authorizations.
• Institutes changes and updates workflows as necessary as a response to insurance, healthcare, and organizational changes.
• Supervises authorization and referral staff. Ensures adequate staffing. In collaboration with resource departments, responsibilities include hiring, motivating, evaluating, disciplinary actions, staff training and development, promoting teamwork and fostering a positive work environment.
• Keeps up to date with insurance and referral requirements.
• Ensures teams are adhering to departmental guidelines and operational expectations.
• Updates and maintains reporting for department.
• Serves as an escalation point for staff to resolve service, patient and referral process concerns. Assists in resolution for issues.
• Implements improvements to departmental workflows and processes.
• Builds resources and team materials.
• Ensures compliance with ARC standards as well as applicable federal, state, and local laws.
• Meets staffing requirements as determined by the management team, in a manner that effectively and efficiently meets the needs of the organization.
• Builds communication and teamwork by holding regularly scheduled meetings with Supervisors and/or Team Leaders.
• Coordinates with Supervisor and Human Resources to ensure proper counseling or discipline documentation occurs, as appropriate.
• Reviews reports on productivity and quality with Supervisors and/or Team Leaders.
• Collaboratively works between operations and clinic management.
• Assists with development and/or implementation of department-specific policies, procedures, and programs and monitors adherence to system-wide policies/standardizations.
• Attends administrative and executive meetings as necessary to deliver reports and updates regarding the CART team.
• Assists with coverage, training, scheduling, and overall responsibilities as it pertains for Holiday shifts.
• Serves and actively participates on various committees or meetings as a voice for the department.
• Adheres to all company policies, including but not limited to, OSHA, HIPAA, compliance and Code of Conduct.
• Regular and dependable attendance.
• Follows the core competencies set forth by the Company, which are available for review on ARC Sharepoint.

 OTHER DUTIES AND RESPONSIBILITIES

• Attends system meetings as invited.
• Involvement in organizational development through meeting attendance and committee involvement.
• Responsibilities occasionally may require an adjusted work schedule and evening/weekend hours in order to meet deadlines.
• Performs other duties as assigned.

QUALIFICATIONS

Education and Experience

Required:

• At least four (4) or more years of supervisory experience; and
• Previous experience in insurance authorizations; and

• Bachelor’s degree in healthcare administration, Business, or related field with two (2) or more years of experience in a clinic or similar healthcare related setting

          OR

• High school diploma or equivalent with four (4) or more years of experience in a clinic or similar healthcare related setting.

Knowledge, Skills and Abilities

• Strong knowledge in business office functions and ability to serve as a resource to staff.
• Knowledge of medical insurance and authorization requirements.
• Knowledge of medical terminology.
• Strong communication and interpersonal skills.
• Excellent computer and keyboarding skills, including familiarity with Windows.
• Excellent verbal and written communication skills.
• Skill with operating PC and using the following software applications: MS Outlook, Word, Excel, and Microsoft Office OneNote.
• 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.