Authorization & Referral Coordinator I

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 Authorization and Referrals Supervisor, supports patient care in an inbound high volume call center environment seeking to provide a positive experience for each call. Answers incoming phone calls related to authorization and referrals and assists in the coordination of care for patients that are referred to a specialist and/or other services. 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

· Answers incoming phone calls related to authorizations and referrals, adhering to schedule with assigned breaks and lunches.

· Maintains basic understanding of insurance authorization and/or referral requirements.

· Understands and communicates important authorization and/or referral information to patient and/or specialist in a timely manner.

· Responsible for coordinating medical record information for transmission to specialist’s office. · Responsible for creating authorization and referral requests as needed.

· Coordinates with Primary Care Offices and Specialty offices as needed.

· Works efficiently with all departments to promote teamwork within the organization.

· Attends Authorization & Referral Meeting regularly.

· Informs management of any issues causing a delay in process.

· 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.

OTHER DUTIES AND RESPONSIBILITIES

● 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. Previous experience in a high volume customer service environment and/or experience with Avaya 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.

● Knowledge of medical terminology.

● Strong communication and interpersonal skills.

● Excellent computer and keyboarding skills, including familiarity with Windows and Adobe products.

● Excellent verbal and written communication skills.

● Ability to adhere to an assigned schedule with little deviation.

● Manual dexterity and sitting is required in carrying out position.

● Ability to provide excellent customer service.

● Ability to troubleshoot basic system issues.

● 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. Remote Opportunity once in person training is completed.