Senior Referral & Prior Auth Specialist

University of Rochester; San Antonio (TX); On-site; USD 57,859,000 - 78,523,000; Full time

Job summary

The University of Rochester is seeking a dedicated referrals and scheduling specialist to support the CVSL RCPG & Cardiac Rehab department in Rochester, NY. You will coordinate referrals, manage prior authorizations, and serve as a patient advocate, ensuring accurate scheduling and effective communication with patients and providers.

You will handle complex insurance interactions, verify patient information, and assist with documentation in the electronic health record to support timely care

Responsibilities

• Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines.
• Communicates regularly with patients, families, clinical and non-clinical staff to identify barriers to appointment compliance and insurance issues.
• Plans, executes, appeals and follows through on all aspects of the process affecting scheduling, care and follow up.
• Prepares and provides complex details to insurance or workers' compensation carriers to obtain prior authorizations.

Job description

The University of Rochester is seeking a dedicated referrals and scheduling specialist to support the CVSL RCPG & Cardiac Rehab department in Rochester, NY. You will coordinate referrals, manage prior authorizations, and serve as a patient advocate, ensuring accurate scheduling and effective communication with patients and providers.

You will handle complex insurance interactions, verify patient information, and assist with documentation in the electronic health record to support timely care