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Authorization & Referral Center Specialist

Company: saltzer health
Location: Nampa
Posted on: November 22, 2021

Job Description:

Position: Authorization & Referral Center Specialist (ARC)Location: Nampa, IDStatus: Full-time + JOB SUMMARY The ARC Specialist assists providers and patients by authorizing procedures and coordinating referral appointments. This position is a highly visible customer service and patient-focused role that works directly with patients, families, providers, outside vendors, insurance representatives, and other medical personnel in a dynamic and professional environment. This fast-paced position requires a thorough understanding of insurance plans, networks, and authorization requirements. + DUTIES AND RESPONSIBILITIES + Authorization & Referral Center Responsibilities + Promote excellence in service, quality, philosophy, and performance. + Coordinate and process authorizations and referrals to completion with precision, detail, and accuracy. + Process authorizations and referrals in a timely manner, including procedures, surgeries, and office visits. + Document detailed information in the EMR and any actions taken regarding authorization status, coverage issues, restrictions, and appointment details. Notifies patients and providers of services requested that are not authorized by insurance. + Participate in quality assurance and quality improvement activities based on customer satisfaction, employee satisfaction, process/system refinement, and financial impact. + Demonstrate the ability to act with diplomacy, sensitivity and confidentiality as a patient and employee advocate. + Perform other duties and responsibilities as assigned. + Knowledge, Skills and Abilities + Must be detail-oriented, possess the ability to multi-task, prioritize work, and be open to cross-functional training in referral and authorization duties. + Maintain confidentiality in matters relating to patient/family. Interact with patients/families with a variety of developmental and socio-cultural backgrounds. + Maintain professional relationships and convey relevant information to other members of the healthcare team within our facilities and with others in the community. + + Professional Communication + Communicate accurate and pertinent information with providers and staff to facilitate effective and efficient patient care, and operations. + Provide and promote effective flow of information and work processes. + Maintain confidentiality in matters relating to staff, providers and patients/family. + Excellent communication skills to include oral and written comprehension/expression. + + Teamwork + Work closely with providers, clinic staff members, and administration to foster a positive and team-oriented work environment. + Accept additional assignments based on qualifications and competencies of self and of other staff members, patient census or acuity, or general needs of the practice. + Initiate problem solving and conflict resolution skills to foster effective work relationships with peers. + + Professional Development + Attend staff meetings, in-services, and continuing education. + Complete and/or provide timely input to annual reviews of staff. + Ability and willingness to demonstrate and maintain competency as required for job title and the area(s) of assignment. + JOB REQUIREMENTS + Experience and significant knowledge of physician office workflow and processes. + Ability to manage a chaotic and complex work environment related to changing staff levels, patient needs, new projects, and the growth trajectory of the organization. + Ability and willingness to exhibit behaviors consistent with standards for performance improvement and organizational values. + Graduation from an accredited high school or equivalent. + Thorough understanding of insurance plans, networks, and authorization requirements. Powered by JazzHR

Keywords: saltzer health, Nampa , Authorization & Referral Center Specialist, Other , Nampa, Idaho

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