Revenue Cycle Insurance Authorization Refer

CommonSpirit Health; Chicago (IL); On-site; USD 42,000 - 54,000; Full time

Job summary

CommonSpirit Health is seeking an Insurance Authorization & Referral Specialist to streamline patient intake by securing authorizations and referrals for hospital procedures and multi-specialty services. You will handle pre-registration, verify insurance details, check medical necessity, and collect pre-service payments while guiding staff on authorization requirements.

You will maintain accurate data across systems, support training for new hires, and assist with complex inquiries to ensure a

Qualifications

• High School Graduate or GED with any medical course of study from an accredited institution.
• Two years of medical office, authorization or hospital environment experience.

Responsibilities

• Obtain timely authorizations and referrals for diverse hospital procedures and multi-specialty medical services.
• Conduct thorough pre-registration duties, including insurance verification, medical necessity checking, and pre-service payment collection.
• Accurately maintain and update patient and insurance data across hospital and clinic information systems.
• Provide ongoing training and support to staff members regarding authorization workflows and essential documentation requirements.
• Resolve patient account inquiries with empathy and professionalism, enhancing the overall patient experience.
• Collaborate with clinical personnel and third-party payers to ensure seamless coordination of care and financial services.

Skills

Insurance verification

Authorization workflows

Customer service

Data entry

Education

High School Diploma or GED

Tools

Hospital information systems

Job description

Job Summary and Responsibilities

As ourInsurance Authorization & Referral Specialist, you will serve as a vital link in the patient care journey at Yavapai Regional Medical Center. You will be responsible for streamlining the patient intake process by securing necessary authorizations and referrals for hospital procedures and multi-specialty services. By maintaining a focus on accuracy and efficiency, you will ensure that our clinical operations run smoothly while upholding the core values of respect, integrity, and accountability in every patient interaction.

Every day you will manage pre-registration tasks, including the collection of comprehensive patient demographics, guarantor information, and insurance details. You will perform essential medical necessity checks, facilitate pre-service collections, and act as a primary point of contact for patients, clinical staff, and third-party payers. Additionally, you will serve as an internal resource for office teams, providing expert guidance on authorization requirements and assisting with complex account inquiries to ensure a seamless experience for both our internal departments and external clients.

To be successful in this role, you will bring a sharp eye for detail and a commitment to providing high-quality customer service in a fast-paced healthcare environment. You will possess the ability to navigate complex hospital systems with precision, ensuring that all data is entered accurately and in compliance with hospital policies. As a collaborative professional, you will support your team by assisting with the training of new hires, maintaining an up-to-date knowledge of evolving industry trends, and demonstrating the flexibility needed to thrive within our dedicated healthcare network.

Key Responsibilities:

• Obtain timely authorizations and referrals for diverse hospital procedures and multi-specialty medical services.
• Conduct thorough pre-registration duties, including insurance verification, medical necessity checking, and pre-service payment collection.
• Accurately maintain and update patient and insurance data across hospital and clinic information systems.
• Provide ongoing training and support to staff members regarding authorization workflows and essential documentation requirements.
• Resolve patient account inquiries with empathy and professionalism, enhancing the overall patient experience.
• Collaborate with clinical personnel and third-party payers to ensure seamless coordination of care and financial services.

Job Requirements

Required:

• High School Graduate or GED and a combination of experience and education in a medical course of study from an accredited institution
• Two years of medical office, authorization or hospital environment experience

Where You'll Work

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.