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.

Obtains authorizations and referrals to support the efficient and effective operation of Yavapai Regional Medical Center and the Physician Care practices. Provides services for pre-registration, pre-service collections, medical necessity checking, referring patients to appropriate sources for follow up as needed. Uses outstanding customer service skills to meet the client intake and information services of both our internal and external customers. INTER-RELATIONSHIPS: Has frequent contact with hospital and clinic personnel, third party payers, Patient Financial Services and with patients and their families.

• The Insurance Authorization/Referral Specialist is expected to perform while exemplifying the five YRMC values of respect, integrity, accountability, commitment and quality. In interacting with others the Insurance Authorization/Referral Specialist is expected to: 1) maintain and enhance the self-esteem of others, 2) listen and respond to others using empathy, 3) ask for help from others in solving problems, 4) share thoughts and rationale with others, 5) provide support without removing the responsibility of others.
• 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.

Required

• High School Graduate and Two years of medical office, authorization or hospital environment experience, upon hire or
• High School GED and A combination of experience and education in a medical course of study from an accredited institution , upon hire
• None, upon hire