Healthcare Outcomes Performance Co. (HOPCo)
Referral and Authorization Coordinator
Healthcare Outcomes Performance Co. (HOPCo), Phoenix, Arizona, United States, 85003
Referral and Authorization Coordinator
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Benefits
Salary $18-20
Supporting CISH (Core Institute Specialty Hospital) and Elevation Surgery centers
Competitive Health & Welfare Benefits
Monthly $43 stipend to use toward ancillary benefits
HSA with qualifying HDHP plans with company match
401k plan after 6 months of service with company match (Part-time employees included)
Employee Assistance Program that is available 24/7 to provide support
Employee Appreciation Days
Employee Wellness Events
Minimum Qualifications
Must have healthcare experience with Managed Care Insurance, requesting referrals, authorizations for insurance, and verifying insurance benefits.
In-depth knowledge of insurance plan requirements for Medicaid and commercial plans.
Minimum two to three years of experience in a healthcare environment with prior authorization experience.
Essential Functions
Verifies and updates patient registration information in the practice management system.
Obtains benefit verification and necessary authorizations (referrals, precertification) prior to patient arrival for all ambulatory visits, procedures, injections, and radiology services.
Uses online, web-based verification systems and reviews real-time eligibility responses to ensure accuracy of insurance eligibility.
Creates appropriate referrals to attach to pending visits.
Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
Completes chart‑prepping tasks daily to ensure smooth check‑in process for the patient and clinic.
Researches all information needed to complete registration process including obtaining information from providers, ancillary services staff and patients.
Fax referral form to providers that do not require any records to be sent. Processes 75‑80 referrals on a daily basis. For primary specialty office visits, fax referral/authorization form to PCPs and insurance companies in a timely fashion.
Reviews and notifies front office staff of outstanding patient balances.
Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
Responds to in‑house provider and support staff questions, requests, and concerns regarding the status of patient referrals, care coordination or follow‑up status.
Identifies and communicates trends and/or potential issues to management team.
Indexes referrals to patient accounts for existing patients.
Creates new patient accounts for non‑established patients to index referrals.
Demonstrates current competencies for job position.
Location: Phoenix, AZ
Salary $1,500.00-$3,800.00
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1 day ago Be among the first 25 applicants
Get AI-powered advice on this job and more exclusive features.
Benefits
Salary $18-20
Supporting CISH (Core Institute Specialty Hospital) and Elevation Surgery centers
Competitive Health & Welfare Benefits
Monthly $43 stipend to use toward ancillary benefits
HSA with qualifying HDHP plans with company match
401k plan after 6 months of service with company match (Part-time employees included)
Employee Assistance Program that is available 24/7 to provide support
Employee Appreciation Days
Employee Wellness Events
Minimum Qualifications
Must have healthcare experience with Managed Care Insurance, requesting referrals, authorizations for insurance, and verifying insurance benefits.
In-depth knowledge of insurance plan requirements for Medicaid and commercial plans.
Minimum two to three years of experience in a healthcare environment with prior authorization experience.
Essential Functions
Verifies and updates patient registration information in the practice management system.
Obtains benefit verification and necessary authorizations (referrals, precertification) prior to patient arrival for all ambulatory visits, procedures, injections, and radiology services.
Uses online, web-based verification systems and reviews real-time eligibility responses to ensure accuracy of insurance eligibility.
Creates appropriate referrals to attach to pending visits.
Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
Completes chart‑prepping tasks daily to ensure smooth check‑in process for the patient and clinic.
Researches all information needed to complete registration process including obtaining information from providers, ancillary services staff and patients.
Fax referral form to providers that do not require any records to be sent. Processes 75‑80 referrals on a daily basis. For primary specialty office visits, fax referral/authorization form to PCPs and insurance companies in a timely fashion.
Reviews and notifies front office staff of outstanding patient balances.
Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
Responds to in‑house provider and support staff questions, requests, and concerns regarding the status of patient referrals, care coordination or follow‑up status.
Identifies and communicates trends and/or potential issues to management team.
Indexes referrals to patient accounts for existing patients.
Creates new patient accounts for non‑established patients to index referrals.
Demonstrates current competencies for job position.
Location: Phoenix, AZ
Salary $1,500.00-$3,800.00
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