Job Information
Arizona Employer Referral Authorization Specialist - SVMG in Sierra Vista, Arizona
This job was posted by https://www.azjobconnection.gov : For more information, please see: https://www.azjobconnection.gov/jobs/6729593
Position Summary:
The Referral/Authorization Specialist is responsible for servicing the needs of members, providers, and the Health Plans representatives. Obtains referral authorization from insurance carriers and relays such authorizations (or denials) to the patient and the provider. Carry out provider orders, such as standing orders and referrals. Verifies procedure codes are accurate on orders before sending. Resolves all pre-authorization, registration, or other referral-related issues prior to a patient\'s appointment. Upload/prepare for upload patient portal documents, including test results, visit summaries, etc. Assist with phones as necessary. Verifies members eligibility and benefits with subsequent notification to designated staff of eligibility issues. Notifies required parties within the appropriate timeframe for routine and urgent requests for services. May process/coordinate medical records requests. Complete orders for additional services based on notes from provider, finishing these tasks within the Electronic Medical Records (EMR) Athena Net. Understand those insurance plans which require prior authorizations for services and relay information to providers/patients as necessary. Ensure length of referral/number of visits is properly documented within Athena Net. All other duties as assigned.
