Insurance Authorization Refer

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.

The Insurance Authorization/Referral Specialist will perform the following

Obtains authorizations and referrals for hospital procedures and multi-specialties services in a timely manner.
Accurately enters patient and authorization information into both the hospital and clinic system.
Provides training to office staff regarding required information for authorizations Assists clients and staff with basic client account questions.
 Keeps current with trends and developments related to essential job competencies.
Prior to the patient's scheduled procedure, pre-registers patient encounters by collecting complete and accurate patient demographic and guarantor information; collecting complete and accurate insurance information; requesting pre-services payment and checking for medical necessity.
Assists in the orientation and training of new employees.
Maintains knowledge of current hospital policies.
Attends staff meetings and in-services as scheduled.
Demonstrates flexibility in job assignments and scheduling.

The job summary and responsibilities listed above are designed to indicate the general nature of the work performed within this job. They are not designed to contain or be interpreted as a comprehensive inventory of all job responsibilities required of employees assigned to this job. Employees may be required to perform other duties as assigned.

• High School Diploma/GED

• Minimum two (2) years experience with the referral/authorization process and interacting with insurance carriers

Preferred

• College level business courses helpful

• Preferred scheduling experience in a Radiology setting

• Familiarity with the referral/authorization process and interacting with insurance carriers