MarinHealth
Referral and Authorizations Coordinator, Access Department, (Novato), Full-Time,
MarinHealth, Novato, California, United States, 94949
Referral and Authorizations Coordinator, Access Department, (Novato), Full-Time, Days
The Referral and Authorizations Coordinator provides medical administration support to providers by obtaining referral or prior authorizations for patients to see specialty providers. Serves as a resource to providers, clinic leaders, and the Patient Access Department regarding the referral and authorization process. Overview
Join MarinHealth, an integrated, independent healthcare system with deep roots throughout the North Bay. MarinHealth comprises MarinHealth Medical Center, a 327-bed hospital in Greenbrae, and 55 primary care and specialty clinics in Marin, Sonoma, and Napa Counties. We attract healthcare’s most talented professionals who value innovation and high-quality, patient-centered care. Work Details
Work Shift:
8 Hour (days) (United States of America) •
Scheduled Weekly Hours:
40 Responsibilities
Accurately processes referral requests and obtains necessary authorizations in compliance with the Referral Management Program. Collaborates with physician office staff to ensure accuracy, timely handling, and appropriate scheduling of referral appointments within the correct departments. Maintains positive working relationships with payer representatives including Managed Care; processes authorization and referral requests for members in coordination with health plans and contracted providers. Communicates with patients in their preferred method (online secure messaging, telephone, or written) throughout the referral process to ensure services are rendered. Complies with HIPAA and confidentiality policies and procedures. Supports completion of work queue items; referral processing, registration and insurance verification activities. Establishes and maintains collaborative relationships with providers and Patient Access staff to ensure smooth record flow and high-quality service. Arranges and maintains medical records for proper order and easy retrieval, maintaining confidentiality and security of records. Supports HIM as necessary to scan documents such as lab results, hospitalizations, discharge forms, and other documents pertaining to the patient or requested appointment. Ensures all work meets quality standards and is completed in a timely manner. Performs other duties as assigned. Qualifications
Education:
High school diploma or GED required. Experience:
2 years of experience in a health care setting; 2 years of experience with insurance prior authorizations, referrals, and electronic health record systems. Skills and Knowledge:
Medical terminology; CPT/HCPCS/ICD terminology knowledge; ability to exercise discretion and independent judgment; proficiency with Microsoft Office; active listening and strong communication skills; organizational skills with attention to detail; Epic and/or APeX experience preferred. General Skills:
Knowledge of patient access, financial counseling, ambulatory settings; understanding of insurance and medical terminology; EMTALA and consent laws knowledge; ability to manage multiple tasks and maintain data accurately; confidentiality and data security. Compensation and Requirements
Pay Range:
$22.50 - $31.50 per hour The compensation listed is in compliance with applicable laws and based on skills, experience, internal/market factors, and qualifications. Some roles may be governed by collective bargaining agreements. Incumbent Standards
MarinHealth is a diverse community committed to C.A.R.E.S: Communication, Accountability, Respect, Excellence, and Safety. We prioritize the well-being of employees, patients, and the community. Immunization requirements apply for employment and ongoing annually thereafter, with medical or religious exemptions considered. Seniority level
Entry level Employment type
Full-time Job function
Health Care Provider Industries
Hospitals and Health Care
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The Referral and Authorizations Coordinator provides medical administration support to providers by obtaining referral or prior authorizations for patients to see specialty providers. Serves as a resource to providers, clinic leaders, and the Patient Access Department regarding the referral and authorization process. Overview
Join MarinHealth, an integrated, independent healthcare system with deep roots throughout the North Bay. MarinHealth comprises MarinHealth Medical Center, a 327-bed hospital in Greenbrae, and 55 primary care and specialty clinics in Marin, Sonoma, and Napa Counties. We attract healthcare’s most talented professionals who value innovation and high-quality, patient-centered care. Work Details
Work Shift:
8 Hour (days) (United States of America) •
Scheduled Weekly Hours:
40 Responsibilities
Accurately processes referral requests and obtains necessary authorizations in compliance with the Referral Management Program. Collaborates with physician office staff to ensure accuracy, timely handling, and appropriate scheduling of referral appointments within the correct departments. Maintains positive working relationships with payer representatives including Managed Care; processes authorization and referral requests for members in coordination with health plans and contracted providers. Communicates with patients in their preferred method (online secure messaging, telephone, or written) throughout the referral process to ensure services are rendered. Complies with HIPAA and confidentiality policies and procedures. Supports completion of work queue items; referral processing, registration and insurance verification activities. Establishes and maintains collaborative relationships with providers and Patient Access staff to ensure smooth record flow and high-quality service. Arranges and maintains medical records for proper order and easy retrieval, maintaining confidentiality and security of records. Supports HIM as necessary to scan documents such as lab results, hospitalizations, discharge forms, and other documents pertaining to the patient or requested appointment. Ensures all work meets quality standards and is completed in a timely manner. Performs other duties as assigned. Qualifications
Education:
High school diploma or GED required. Experience:
2 years of experience in a health care setting; 2 years of experience with insurance prior authorizations, referrals, and electronic health record systems. Skills and Knowledge:
Medical terminology; CPT/HCPCS/ICD terminology knowledge; ability to exercise discretion and independent judgment; proficiency with Microsoft Office; active listening and strong communication skills; organizational skills with attention to detail; Epic and/or APeX experience preferred. General Skills:
Knowledge of patient access, financial counseling, ambulatory settings; understanding of insurance and medical terminology; EMTALA and consent laws knowledge; ability to manage multiple tasks and maintain data accurately; confidentiality and data security. Compensation and Requirements
Pay Range:
$22.50 - $31.50 per hour The compensation listed is in compliance with applicable laws and based on skills, experience, internal/market factors, and qualifications. Some roles may be governed by collective bargaining agreements. Incumbent Standards
MarinHealth is a diverse community committed to C.A.R.E.S: Communication, Accountability, Respect, Excellence, and Safety. We prioritize the well-being of employees, patients, and the community. Immunization requirements apply for employment and ongoing annually thereafter, with medical or religious exemptions considered. Seniority level
Entry level Employment type
Full-time Job function
Health Care Provider Industries
Hospitals and Health Care
#J-18808-Ljbffr