Referral Authorization Manager
Description:
Referral Authorization Manager
La Brea - Los Angeles, CA 90016
Overview
Salary Range $70,304.00 - $75,000.00 Salary/year
Description
Under the direction of the Director of Patient Services, this position is responsible for the oversight of the department performance, staffing, and referral clerks/coordinators supervision.
Essential Duties and Responsibilities:
Manage and train, evaluate direct reports
Manage staff schedules and approve time and attendance
Provide necessary and routine reports
Streamline existing referral processes and protocols, and standard operating procedures across clinics.
Monitor daily referral & prior authorization turnaround time and conversion rates to identify operational obstacles, providing resolutions.
Review and analysis for all referral/authorizations submitted by the health centers timely and accurately
Communicate with providers, clinical, and non-clinical support staff
Ensure medical documentation meets the billing and approval standards of insurance carriers.
Ensure regulatory compliance with required submission timelines
Proficient written and verbal communication
Adhere to company policy and procedures
Qualifications
4 years of progressive experience processing referrals and pre-authorizations in a medical administration or referral coordination role.
1-2 years of experience managing direct reports.
Bilingual in Spanish (required).
Advance knowledge with medical terminology, IPA processes, and ICD, CPT codes
Experience working in a professional setting, healthcare related and/or supervisory experience, FQHC experience preferred
Experience with ECW and E-Consult
Highschool graduate or higher education
Ability to work with population or diverse cultural, educational, social, and economic backgrounds