Authorization & Referral Specialist - Imaging Procedures and Referrals (Las Vegas)

The Cure4TheKids Accountability Creed

We are reliable, trustworthy and act with integrity

  • We stand ready to be counted upon to do the right thing for the health and highest interest of our patients, our team and for the organization.
  • We own and are responsible for our actions and outcomes.
  • We take responsibility for our own work and efforts and do not assign cause or blame toward others for the results we are generating.
  • We hold ourselves accountable for the Patient Experience. We are answerable as individuals and team members for all interactions our patients have with our organization, we are in charge of patient perceptions, across the continuum of care we provide.

We are transparent and open in our communication both individually and as a team.

  • We are open and respectful in our communication. We do not speak poorly of others and bring our challenges and grievances openly to our team and manager.

We are responsible for doing our part for patient outcomes through continuous quality improvement and service excellence

  • We are focused on personal, professional and clinical excellence and improving our skills and awareness as a contributing team member. We are open to feedback and training to improve ourselves and the organization.

If you said yes to all of these questions and feel you can add to our culture, please keep reading?

Important/Critical to the interview process to be considered for our team:

The following Accountability Creed is a crucial part of our culture and interview process. We consider our initial interactions as a mutual interview. Are you right for us and are we right for you. Be prepared to speak about how you feel about being part of a culture that embodies this creed. If in the initial phone interview, when you are asked to share your thoughts about the Accountability Creed, if you are unclear or do not recall reading it, you will not proceed in the interview process.

WHAT IT TAKES TO BE PART OF OUR TEAM

Are you an exceptional Authorization & Referral Specialist who absolutely thrives on being part of an accountable team? Can you dedicate yourself to being part of a team serving the needs of children and their families? Do you bring the highest standards of integrity and professionalism to your team? Do you thrive in an environment where you are valued and appreciated for who you are, how hard you work and for that something special you bring to the teams you choose to work with? Are you looking for an organization that offers competitive compensation and one of the broadest and most comprehensive benefit packages available in the field of healthcare?

This is a role that requires a multi-disciplinary team approach to solving problems and patient challenges. We frown upon elitists who often use the phrase "that's not my job" or "someone else can do it". The primary goal is to bring the best patient care and experience for our area's sickest children, not about feeding anyone's ego.

SUMMARY: Authorizations and Referrals Specialists ? Imaging Procedures and Referrals are responsible for providing prompt and courteous customer service to patients and providers, scheduling and obtaining prior authorizations for imaging and other procedures, processing referrals for in and out of area physicians, medical facilities, and testing centers. Authorization and Referral Specialists ? Imaging Procedures and Referrals perform complex clerical procedures related to obtaining prior authorizations and ensure patient appointments have been scheduled, and outcomes of services are completed and obtained. This is a non-exempt position that reports directly to the Authorizations and Referrals Specialists Supervisor.

ESSENTIAL DUTIES AND RESPONSIBILITIES

  1. Utilize clinical data/knowledge to assist patients in gaining appropriate physician, hospital, medical group and community referrals.
  2. Utilize computer software to process referrals and maintain up-to-date referral databases.
  3. Facilitate scheduling of appointments.
  4. Obtain prior authorizations for imaging studies and other procedures ordered by practice providers utilizing payer authorization tools including forms, websites and telephone or fax lines.
  5. Maintains current patient files updated with the most current coverage provided.
  6. Monitors department voice mail, Qliq, email, Teams messages and processes prior authorization requests in accordance with departmental guidelines.
  7. Maintains telephone service standards and returns patient messages within one (1) business day.
  8. Act as a point of contact for assigned providers to answer and route questions about patient care.
  9. Efficiently manage a high volume of imaging, procedure and referral requests.
  10. Process patient referrals in a timely manner.
  11. Perform routine administrative and clerical tasks to keep the offices of physicians and other health practitioners running smoothly including answering telephones, communicating with patients, and communicating with physicians.
  12. Administrative duties may include but are not limited to the following:
  • Answer telephones; taking complete and accurate messages
  • Fill out insurance forms
  • Handle correspondence
  • Schedule appointments
  • Arrange for ancillary services
  • Collection of medical records
  • Review and collection of physician orders
  • Perform other administrative duties as directed

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