Referral/Prior Authorization Specialist

Referral/Prior Authorization Specialist Forte Family Practice - 3.1 Las Vegas, NV Job Details Full-time $16 - $18 an hour 3 hours ago Benefits Dental insurance Paid time off Vision insurance 401(k) matching Employee discount Qualifications Collaborate with healthcare professionals Record keeping Insurance prior authorization Managed care Achieving HIPAA compliance Maintaining patient confidentiality Medical office experience HIPAA Mid-level Administrative experience Medical administrative support

ICD-9 ICD-10

Records management Clinical documentation Medical billing Organizational skills Dental office experience Patient interaction Managing patient records Care coordination Referral coordination Medical terminology Communication skills Office experience Full Job Description Overview Join our dynamic team as a Referral/Prior Authorization Specialist, where your expertise will drive seamless coordination between healthcare providers, insurance companies, and patients. In this vital role, you'll facilitate the referral process to ensure timely access to quality care, manage medical documentation with precision, and uphold the highest standards of confidentiality. Your proactive approach and attention to detail will help optimize patient outcomes and streamline administrative workflows in a fast-paced healthcare environment. Responsibilities Coordinate and process patient referrals across various healthcare disciplines, ensuring accuracy and completeness of all documentation. Verify insurance coverage and benefits through managed care systems to facilitate smooth authorization processes. Maintain thorough knowledge of medical terminology, CPT (Current Procedural Terminology) codes, ICD-9, ICD-10 (International Classification of Diseases), and ICD coding standards for accurate record-keeping. Review and update medical records while adhering strictly to HIPAA regulations to protect patient privacy. Communicate effectively with medical offices, insurance providers, and patients to resolve referral issues promptly. Conduct insurance verification procedures to confirm patient eligibility and coverage details prior to service delivery. Support medical coding activities related to referrals, ensuring compliance with industry standards and billing requirements. Requirements Prior experience working in a medical office or dental office environment with familiarity in medical records management. Strong understanding of managed care processes, insurance verification, and healthcare billing practices. Knowledge of HIPAA regulations and best practices for safeguarding protected health information (PHI). Proficiency in medical terminology, CPT coding, ICD-9, ICD-10, and ICD coding systems. Experience handling medical records with accuracy and confidentiality. Excellent communication skills for liaising with healthcare providers, insurance companies, and patients effectively. Office experience demonstrating organizational skills and attention to detail in a fast-paced setting. Join us as a Referral Specialist and be part of a dedicated team committed to delivering exceptional healthcare coordination!

Pay:

$16.00 - $18.00 per hour

Benefits:

401(k) matching Dental insurance Employee discount Paid time off Vision insurance

Work Location:

In person