Referral and Authorization Specialist

Asante


Date: 22 hours ago
City: Medford, OR
Contract type: Full time
Additional Position Details: FTE: 1.000000 | Full Time | 1st Shift - Days

Position Summary

The Referral and Authorization Specialist is responsible for processing all referrals from assigned area of specialty. This includes securing pre-authorizations when necessary to facilitate timely appointments and support continuity of care within the health system.

As a Referral and Authorization Specialist for Asante, you will have the opportunity to:

  • Receive and transcribe all referrals in Asante's referral tracking system, assist with coordinating the scheduling of care based on clinical protocols, and send confirmation for scheduled services to the patient.
  • Ensure patient demographic and insurance information accompanying the referral is accurate and complete and follow up with referring clinics and/or patients as needed to fill in missing or incorrect information.
  • Obtain pre-authorizations and pre-certifications from third-party payers in accordance with payer requirements and document the authorization number and period of validity in referral.
  • Gather additional medical records from other providers as needed to support medical necessity when obtaining a preauthorization and follow up with payers on pre-authorization requests as needed.
  • Identify patients who will need to receive Medicare Advance Beneficiary Notices of Noncoverage, along with Waivers for Oregon Health Plan and Commercial insurance patients.
  • Accurately enter all referral information into appropriate systems daily in order to schedule the initial evaluation and follow up appointments as needed.
  • Ensure Therapists have all clinical information necessary for referral appointments & authorization forms and sending any additional documents upon request.
  • Alert the therapist involved in the patient's care when there are issues with referrals or complications with insurance coverage.
  • Inform the patient whether the authorization for the referral has been approved or denied, and discusses what other possible form of payment may be applicable.

Qualifications

  • Associate Degree in business or healthcare related field, preferred
  • Minimum of 2 years of healthcare related insurance, scheduling, front desk, or comparable experience is required
  • CHAA: Certified Healthcare Access Associate is preferred

Total Rewards Package

  • Earn a competitive and progressive salary.
  • Benefit from health plans that focus on health and wellness including medical, dental, vision and wellness beginning within 30 days of hire.
  • Plan for your future with a retirement package that includes up to 6% employer contribution.
  • Experience a healthy work-life balance with our generous earned time off (ETO).
  • Continue to enhance your education through our tuition reimbursement and tuition repayment plans.

Explore Asante more by visitingwww.asante.org/careers

At Asante We Believe That We Are Defined By Our Values - The Traits That Guide Us As We Serve Patients And The Community

Excellence - Respect - Honesty - Service - Teamwork

Asante is an equal opportunity employer. We are committed to employ and advance in employment women, minorities, qualified individuals with disabilities and protected veterans.

How to apply

To apply for this job you need to authorize on our website. If you don't have an account yet, please register.

Post a resume

Similar jobs

Environmental Services Assistant

Asante, Medford, OR
1 week ago
Additional Position Details: FTE: 0.600000 | Part Time | 3rd Shift - NightsThis position is eligible for shift differentials for swing, night, and weekend hours!$1.04 extra per hour between 3:00pm and 11:00pm$1.90 extra per hour between 11:00pm and 7:00am$.88 extra per hour for weekend shiftsPosition SummaryAt Asante, the Environmental Services Assistant/Housekeeper will effectively maintain a clean, healthy, safe as possible...

Application Analyst

Asante, Medford, OR
2 weeks ago
Additional Position Details: FTE: 1.000000 | Full Time | 1st Shift - DaysWhy AsanteAsante is more than a great hospital system in an amazing location. We are a community of passionate providers and service-focused caregivers who collaborate to deliver amazing patient outcomes; a place where titles don't matter as much as your creativity, drive, and passion. Our culture, values and...

Respiratory Care Practitioner

Asante, Medford, OR
4 weeks ago
Additional Position Details: FTE: 0.150000 | Flexible Workforce | Variable Schedule DaysSalary: Starting at $33.91 an hour and up (based on qualification years of experience in the field). Plus, you will earn extra shift differentials for swing, night, and weekend hours:$1.73 extra for working between 3:00pm - 11:00pm$3.50 extra for working between 11:01pm and 7:00am$1.54 extra for working weekends Position...