Responsible for the prior authorization and referral process to ensure timely turnaround for services that are performed. Provides information, coordinates medical and legal requests and acts as a resources with regard to payers.
Principle Responsibilities
Processes health plan specific referral requirements including prior authorizations, initiates service and referral process.
Coordinate the care of patients following physician orders and verify insurance coverage.
May manage communication and care coordination process of scheduling patents for appointments, completing documentation and coordinating records.
Acts as a patient liaison with billing offices, providers and payers.
Answers patient questions regarding pricing quotes, information regarding services and insurance coverage questions.
Provides information, coordinates medical and legal requests and acts as a resource regarding payers.
Coordinate medical and legal communications, scheduling of depositions and attorney conferences.
Uses electronic medical record and other electronic tools.
May process timecards and timecard adjustments.
May order supplies
May provide back up coverage for various tasks.
Other duties as assigned.
Job Requirements
Must be 18 years of age with education and/or experience needed to meet required functional competencies as listed on the job description, and High school diploma or GED preferred
0 to 2 years of health care experience required
0 to 2 years of experience with HMO, Medical Assistance/Medicare and third party payer referral/authorization process required
0 to 2 years of experience using an electronic medical record, Microsoft Word, Excel and Outlook preferred
Physical Demands
Sedentary
Lifting weight Up to 10 lbs. occasionally, negligible weight frequently
No weekends--No Major Holidays
Benefit Eligible
Seniority level
Entry level
Employment type
Full-time
Job function
Health Care Provider
Industries
Hospitals and Health Care
Referrals increase your chances of interviewing at Allina Health by 2x