Kidney Specialists of Southern Nevada
Referrals & Authorizations Rep
Kidney Specialists of Southern Nevada, Las Vegas, Nevada, us, 89105
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Referrals & Authorizations Rep
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Kidney Specialists of Southern Nevada
Kidney Specialists of Southern Nevada (KSOSN) provides comprehensive kidney care and a full spectrum of kidney disease management resources for residents of Southern Nevada. Our care team educates and empowers patients who are living with kidney pain, infections, stones, and other kidney problems. With this exciting opportunity you will be joining a seasoned team of 65 physicians, nurse practitioners, and physician assistants, as well as 130+ team members across eight locations. We are looking for a dynamic
Referrals and Authorizations Representative
to join our growing team.
Position Summary The Referral and Authorization Representative is responsible for the coordination of patient services, including referrals and authorizations. The primary purpose for this position is to perform the appropriate processes to verify patient eligibility, ensure insurance coverage, and determine if prior authorization is needed. The Referral and Authorization Representative will be committed to creating a quality environment, promoting the patient experience and patient safety, creating an exceptional work experience for our KSOSN team and patients. The Referral and Authorization Representative will partner with the leadership team to achieve KSOSNs goals.
Essential Job Functions
Serves as the primary liaison for all referrals and authorizations needed for KSOSN patients
Facilitates communication between patients, insurance carriers, and providers
Processes and schedules internal and external referrals; submits medical records to insurance carriers to expedite prior authorization processes
Requests, tracks, and obtains prior authorizations both in/out of network and internal/external from insurance carriers and third-party authorization companies including prior authorizations for all medication and office visits
Maintains ongoing tracking and appropriate documentation on referrals and prior authorizations in internal and external systems
Develops and implements prior authorization and referral workflow, policies and procedures
Manages correspondence with insurance companies, physicians, specialists and patients
Develops and maintains relationships with all insurance carriers, representatives, and referral sources
Remains current on insurance changes
Assumes advocate role on the patient's behalf with the carrier to ensure approval of authorization in a timely manner
Maintains documentation in the electronic health record
Other duties as assigned
Benefits
Company-paid holidays
Medical
Dental
Vision
Paid Time Off
Company-paid Life Insurance
Company-paid Short-term Disability
Company-paid Long-term Disability
401(k)
Minimum Requirements
Minimum two (2) years of related experience required.
Knowledge and appropriate use of medical terminology required.
Must have excellent communication and computer skills.
Prior experience working in an urgent care or specialty setting preferred.
Seniority level Entry level
Employment type Full-time
Job function Health Care Provider
Industries Hospitals and Health Care
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Referrals & Authorizations Rep
role at
Kidney Specialists of Southern Nevada
Kidney Specialists of Southern Nevada (KSOSN) provides comprehensive kidney care and a full spectrum of kidney disease management resources for residents of Southern Nevada. Our care team educates and empowers patients who are living with kidney pain, infections, stones, and other kidney problems. With this exciting opportunity you will be joining a seasoned team of 65 physicians, nurse practitioners, and physician assistants, as well as 130+ team members across eight locations. We are looking for a dynamic
Referrals and Authorizations Representative
to join our growing team.
Position Summary The Referral and Authorization Representative is responsible for the coordination of patient services, including referrals and authorizations. The primary purpose for this position is to perform the appropriate processes to verify patient eligibility, ensure insurance coverage, and determine if prior authorization is needed. The Referral and Authorization Representative will be committed to creating a quality environment, promoting the patient experience and patient safety, creating an exceptional work experience for our KSOSN team and patients. The Referral and Authorization Representative will partner with the leadership team to achieve KSOSNs goals.
Essential Job Functions
Serves as the primary liaison for all referrals and authorizations needed for KSOSN patients
Facilitates communication between patients, insurance carriers, and providers
Processes and schedules internal and external referrals; submits medical records to insurance carriers to expedite prior authorization processes
Requests, tracks, and obtains prior authorizations both in/out of network and internal/external from insurance carriers and third-party authorization companies including prior authorizations for all medication and office visits
Maintains ongoing tracking and appropriate documentation on referrals and prior authorizations in internal and external systems
Develops and implements prior authorization and referral workflow, policies and procedures
Manages correspondence with insurance companies, physicians, specialists and patients
Develops and maintains relationships with all insurance carriers, representatives, and referral sources
Remains current on insurance changes
Assumes advocate role on the patient's behalf with the carrier to ensure approval of authorization in a timely manner
Maintains documentation in the electronic health record
Other duties as assigned
Benefits
Company-paid holidays
Medical
Dental
Vision
Paid Time Off
Company-paid Life Insurance
Company-paid Short-term Disability
Company-paid Long-term Disability
401(k)
Minimum Requirements
Minimum two (2) years of related experience required.
Knowledge and appropriate use of medical terminology required.
Must have excellent communication and computer skills.
Prior experience working in an urgent care or specialty setting preferred.
Seniority level Entry level
Employment type Full-time
Job function Health Care Provider
Industries Hospitals and Health Care
#J-18808-Ljbffr