Homeoffice Authorization & Referral Coordinator II presso 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 supervision of the Centralized Authorizations and Referrals Supervisor, is responsible for obtaining authorizations and coordinating the care of patients that are referred to a specialist. 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

• Assists with responsibilities and duties of the Referral Coordinator I role as directed by department leadership.
• Maintains current knowledge of insurance authorization and/or referral requirements.
• Obtains authorizations from insurance carriers in a timely and efficient manner as defined in the department guidelines.
• 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 clinicals to send to insurance as requested.
• Can create, modify and sign referral orders within protocols.
• Responsible for coordinating medical record information for transmission to specialist’s office.
• Ensures authorization and/or referral information is properly documented in Epic as outlined in the department guidelines.
• 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 to patients and leadership.
• Works efficiently with all departments to promote teamwork within the organization.
• 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 CMSweb.
• Works holiday shift(s) as required by Company policy.

OTHER DUTIES AND RESPONSIBILITIES

• Assists with training team members as needed.
• Involvement in organizational development through meeting attendance and committee involvement.
• Responsibilities occasionally may require an adjusted work schedule, overtime, and evening/weekend hours in order to meet deadlines.
• Performs other duties as assigned.

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 strongly preferred. Previous experience in a high-volume customer service environment and/or experience with contact center phone system a plus.

AND

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 knowledge of 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, 8am-5pm. Work from home opportunity once orientation complete.