Job Summary Performs a variety of duties to obtain pre-certification and prior authorization for various procedures and referrals to specialists as determined by FMC physicians requiring customer service skills in with FMC physicians, patients, insurance companies, specialists' office staff and other facilities to obtain authorization for the further care of FMC patients in a timely manner from managed care companies and providing appropriate follow-up with the patient and specialist.
Provides documentation and appropriate information to obtain pre-certification and prior authorization for further care of FMC patients as requested by the FmC physicians in a timely manner. The requests and documentation are provided to managed care companies. Provides patient chart information to specialists as directed. Reorganizes processing as changes occur in insurance plans or in office procedure.
Communicates verbally and in writing using customer service skills with FMC physicians, patients, insurance companies, specialists' office staff and other facilities. Serves as resource to FMC physicians and staff regarding requirements for prior authorization and referrals.
Maintains referral tracking logs for status of each referral. Enters referral information into each patient's referral file in the computer.
Provides follow up with billing problems on the patient's encounter due to referrals including conducting research and letters of clarification.
Internal Number: 2019-16558
Let’s transform healthcare together.
Every day, we bring patients convenient, coordinated access to healthcare while providing meaningful service to our community.
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Develop professionally and achieve your career goals
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Enjoy a compassionate, caring culture with outreach to our local communities
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Welcome to HonorHealth.
We are a non-profit, local healthcare organization known for community service and outstanding medical quality. Our organization encompasses five acute care hospitals with approximately 10,500 employees and 3,100 volunteers, urgent care centers, clinical research, medical education, an inpatient rehabilitation hospital, an Accountable Care Organization, two foundations, and extensive community services.