Referral Prior Authorization Rep - Physician Network

Overview Looking to be part of something more meaningful? At HonorHealth, you’ll be part of a team, creating a multi-dimensional care experience for our patients. You’ll have opportunities to make a difference. From our Ambassador Movement to our robust training and development programs, you can select where and how you want to make an impact. HonorHealth offers a diverse benefits portfolio for our full-time and part-time team members designed to help you and your family live your best lives. Visit honorhealth.com/benefits to learn more. Join us. Let’s go beyond expectations and transform healthcare together. HonorHealth is one of Arizona’s largest nonprofit healthcare systems, serving a population of five million people in the greater Phoenix metropolitan area. The comprehensive network encompasses six acute-care hospitals, an extensive medical group with primary, specialty and urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization, community services and more. With nearly 14,000 team members, 3,700 affiliated providers and hundreds of volunteers dedicated to providing high quality care, HonorHealth strives to go beyond the expectations of a traditional healthcare system to improve the health and well-being of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Referral Coordinator-PN is responsible for coordinating all aspects of specialty referrals, eligibility verification and maintenance for practice patients. This responsibility includes obtaining client information, maintaining patient files, verifying information with appropriate agencies, and reporting statistics and data as required. Processes and approves selected specialists referrals according to criteria and guidelines established in general and PN specifically. Obtains referral request documentation Completes referral authorization/prior authorization in a timely fashion and in accordance with practice requirements. Compiles all pertinent medical data and supporting documentation and faxes or mails to appropriate receiver. Verifies eligibility, benefits and contractual appropriateness. Responsible for recording referral information on Referral Log in order to assist in the tracking of referral numbers and costs to assist in budgetary forecasting and to assure follow-up. Responsible for Electronic Health Records: Continually maintains Health Insurance Portability and Accountability Act (HIPAA) and other compliance requirements. Enters non-clinical information into patient electronic health record (EHR) system. Ensures all required information is keyed in thoroughly and accurately. Views non-clinical information in patient EHR system. Independently formulates information to be entered into EHR system. Obtains information to be entered from multiple sources such as providers, nurses, etc. Logs, tracks, and resolves issues within specific time frame to ensure accuracy and timeliness of data entry. Brings errors and/or issues to the attention of designee. Navigates through multiple complex EHR screens and enters data. Performs other duties as assigned. Qualifications Education High School Diploma or GED Required Experience 6 months in a medical office Required Licenses and Certifications Must demonstrate proficiency in Electronic Health Record post hire by attending required training and passing proficiency test. Required