Coordinator Referral/Pre Auth (Mh)

NKC Health; Kansas City (MO); On-site; USD 38,000 - 59,000; Full time

Benefits offered by this job

Benefits package

Retirement plan

Competitive wages

Paid time off

Holidays

Educational assistance

Day shift

Job summary

NKC Health is hiring a Referral/Pre-Authorization Coordinator for NKC Health OBGYN on the 12th Floor. The role coordinates referrals and pre-authorizations, schedules appointments, and ensures timely completion of the process in collaboration with the health care team.

The ideal candidate will have at least two years in a physician office, strong medical terminology knowledge, and the ability to multitask in a fast-paced clinic environment with a focus on accurate documentation and patient

Qualifications

• High school graduate or GED.
• Minimum two years of experience in a physician office preferred.
• Working knowledge of medical terminology and knowledge of various insurance company requirements for pre-certification and referrals.
• Basic office skills, critical thinking, detail oriented and able to multitask in a fast paced environment.

Responsibilities

• Coordinate outpatient referrals and obtain pre-certifications or prior authorizations.
• Use EMR to capture information for appointments and referrals.
• Educate patients about referral process and physician's office services.
• Coordinate efforts between providers to ensure appointment success.
• Notify physicians when referrals are denied or not kept.
• Complete referral and preauthorization with specialist reports or tests.
• Monitor incoming patient paperwork and flag results for physician review.
• Complete FMLA, ADA and other medical paperwork as directed.

Skills

Office skills

Critical thinking

Attention to detail

Multitasking

Education

High school diploma or GED

Tools

EMR system

Job description

Summary

Here at NKC Health our mission is to empower hope and healing in every life we touch. Whether you are serving patients at a primary care clinic, specialty clinic, or in a support capacity, every team member works together to complete this mission.

NKC Health OBGYN-12th Floor clinic is hiring a Referral/Pre-Authorization Coordinator! If you’re looking for a great opportunity to impact our communities, join our NKC Health team!

Why NKC Health Medical Group?

• Comprehensive Benefits (Medical, Dental, Vision, Life, FSA)
• Employer matched retirement plan
• Competitive wages
• Paid time off for personal/vacation/sick
• Six paid holidays per year
• Educational assistance
• Day shift schedules

What does a Referral/Pre-Authorization Coordinator do?

Under the direction of the Practice Manager or Supervisor, Patient Services, this position is responsible for coordinating and ensuring referrals and/or pre-authorizations are managed and addressed appropriately. Works collaboratively with the health care team and the patient to schedule referral appointments, and independently completes the process for required pre-certification and prior authorizations in a timely manner.

What does a typical day on the job look like?

• Provides quality service by acting as a liaison between healthcare team, patient and specialists to coordinate outpatient referrals and obtain pre-certifications or prior authorizations as necessary.
• Utilizes the EMR system to its full potential in capturing the necessary information needed for making an appointment and communicating necessary information such as referral requirements, patient demographic information, insurance and approval information, and comments about specific patient information key to a successful appointment.
• Provides education to patients about the importance of the referral process and service provided by the physician’s office, which may include subspecialty focus.
• Coordinates efforts between providers, gathering and providing information key to appointment success.
• Communicates to physicians and other health care providers the various requirements and processes involved with medical referral authorizations for the most expedient patient appointment and successful visit.
• Completes the referral and/or preauthorization process by ensuring the specialists’ report or test results are received.
• Notifies the referring physician when a patient does not keep a referral appointment or a pre-authorization is denied.
• Monitors incoming patient paperwork to be scanned and flags results that are to be reviewed by the physician.
• Completes FMLA, ADA and other medical paperwork as directed by the physician.

What are the requirements for the job?

• High school graduate or GED
• Minimum two years of experience in a physician office preferred.
• Working knowledge of medical terminology and knowledge of various insurance company requirements for pre-certification and referrals.
• Basic office skills, critical thinking, detail oriented and able to multitask in a fast paced environment.

Our North Star:

Here at NKC Health, we believe in care empowered. Our actions are the concrete things we do to differentiate ourselves: we lead with heart, we always move forward, and we connect to more.

NKC Health is an Equal Opportunity Employer and values diversity in our organization. We do not discriminate against any applicant for employment or employee on the basis of race, color, religion, gender, age, marital status, sexual orientation, national origin, disability, veteran status or any other classification protected by applicable discrimination laws.