The physicians and staff of the Center for Digestive Health specialize in gastroenterology, which covers all aspects of the digestive system. Our specialty includes diagnostic endoscopic procedures and ultrasounds, liver disease studies, reflux diagnosis and management, and motility studies.

We are dedicated to conducting the highest quality of clinical research, while offering to our patients an option to participate in some of the nation's leading and innovative gastrointestinal research studies.

The Referral and Authorization Specialist coordinates processes, documents medical referrals and prior authorizations for a variety of medical services for clinic patients, as requested electronically by clinic providers. This requires clinical knowledge and understanding of CPT and ICD-9(10) codes to meet the requirements of third party payers and specialty clinics to ensure minimal delay in securing referral appointments or pre-authorizations. 

Responsibilities:

• Completes all required documentation accurately, in a timely manner, and thoroughly in accordance with department standards; in addition, documentation complies with patients' insurance requirements.

• Meets daily referral modification productivity standards adhering to referral processes and guidelines.

• Prepares and processes all referral and pre-authorization paperwork, including gatherings pertinent information as needed via EHR, from incoming phone/email/fax messages, or from clinical team. 

• Contacts various clinics, facilities, and companies to obtain information to accurately complete referral/pre-authorization requests.

• At least 6 months 1 year of experience in a health care setting or similar setting is strongly preferred.

• High school diploma or GED equivalent required.

• Knowledge of Medical Terminology preferred

• Ability to maintain good interpersonal interactions with clients and co-workers

• Ability to multi-task, be flexible, ensure accuracy, and meet changing priorities in a fast-paced, high-workload environment.

• Basic computer literacy (i.e., use system to manage and schedule appointments, access electronic medical record information).

• Clinical knowledge of medical terminology, medical procedures, CPT, and ICD-9 (10).

• Knowledge of insurance providers, their portals and their expectations for authorization approval.

• Written and verbal communication skills, including ability to communicate effectively with patients and family members.  

All your information will be kept confidential according to EEO guidelines.