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Title

Authorization/Referral Specialist 

EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.  
Description

JOB SUMMARY:

The Authorization/Referral specialist works in the Authorization Department within the Centralized Business Office, as a liaison between the physician and the patient. The position interfaces with physicians, patients, and administrative personnel and answers phone calls, responds to fax and email communication and routes messages accordingly. The focus of the position is to obtain prior authorizations for medications and/or procedures.

 

JOB RESPONSIBILITES:

  • Obtains authorizations for ancillary tests and medical procedures.

  • Responsible for coordinating and processing of all patient referrals including specialty and ancillary services.

  • Utilizes a high degree of accuracy in obtaining and verifying that registration, demographic and insurance information is correct and up to date.

  • Acts as liaison between the MSO and other healthcare providers while exhibiting a high level of customer service skills.

  • Performs eligibility checks on members as necessary by telephone or electronically.

  • Follows procedures for proper authorization and processing of all referral services.

  • Supports physicians and patients in synchronizing appointments, authorizations and tests taking place in different practices.

  • Communicates with patient and practice to ensure follow through with referrals.

  • Ensures strict confidentiality of all health records, member information and follows HIPAA guidelines.

  • Completes all administrative functions related with referral activities in an efficient manner.

  • Enters all referral hospital, outpatient and other patient specialty health service authorizations into the EMR and practice management system.

  • Responsible for monitoring all referral reports not received and follow up in a timely manner.

  • Performs duties in honest and ethical manner.

  • Perform other duties as assigned.

In accordance with the New York State Department of Health (DOH) order that all hospitals and nursing homes “continuously require all covered personnel to be fully vaccinated against COVID-19.”  Upon receipt of a conditional job offer, candidates who are not already vaccinated must obtain the first dose of the vaccine within three (3) calendar days of job offer and must obtain any subsequent doses in accordance with the vaccine protocol. The order allows for limited medical exemptions with reasonable accommodations, consistent with applicable law.

Authorization/Referral Specialists must be able to sit for long periods of time, and must have manual dexterity to work computer systems and keyboard. It is reasonable to anticipate lifting 10 -15 pounds in any given day.

 

 

 
Category Business Support  
Exempt/Non-Exempt Non-Exempt  
Location SB Administrative Services, LLC  
Full-Time/Part-Time Full-Time  
Position Requirements

REQUIRED QUALIFICATIONS:

  • High School Diploma/GED minimum.

  • Three (3) years of administrative experience in a medical office setting.

  • Prior pre-authorization process experience.

  • Strong organizational and communication skills (both verbal and written).

  • Excellent typing skills and friendly telephone etiquette.

  • Microsoft Office proficiency.

PREFERRED QUALIFICATIONS:

  • EMR experience.

  • Experience with managed care companies.

  • Familiarity with medical terminology, CPT procedure codes, and ICD-10 codes.

 

 

 
Shift Days  
Tags Benefits,401K, PTO, Life Insurance. Competitive Salary. Office located in Commack  
Salary Range Commensurate with experience.  
Position Authorization/Referral Specialist  
Open Date 10/4/2021  

This position is currently accepting applications.

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