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Wayne State University Physician Group (UPG) — штаб-пәтері Детройтта орналасқан, Мичиганның оңтүстік-шығысындағы пациенттерге қызмет көрсететін коммерциялық емес академиялық медициналық ұйым. Оның 400-ден астам дәрігері мен жоғары білікті медициналық мамандардан тұратын командасы шамамен 50 медициналық бағыт бойынша бастапқы және бейінді медициналық көмек көрсетеді. Қызметтер көпбейінді және бірбейінді клиникалар, жылжымалы медициналық бөлімшелер және қоғамдық денсаулық сақтау бастамалары арқылы қолдау табады. Wayne State University School of Medicine оқу орнымен байланысы арқылы UPG медициналық білім беруге және клиникалық зерттеулерге де үлес қосады. Population Health Accountability Center сияқты бағдарламалар қоғам денсаулығына әсер ететін медициналық, мінез-құлықтық және әлеуметтік факторларды қарастырады.
Remote Referral and Authorization Coordinator - Michigan
Support Wayne Health patients by coordinating referrals, appointments, insurance authorizations, medical records, and payer communications in a remote role.
Сипаттама
- Secure pre-certifications and prior authorizations for procedures and specialist appointments.
- Schedule outpatient testing with external providers for Wayne Health patients.
- Coordinate, document, and process referrals and prior authorizations requested by clinic providers.
- Answer calls from patients and members of the public.
- Schedule imaging, diagnostic, new-patient, and return-patient appointments.
- Make follow-up calls and address complaints.
- Troubleshoot issues and provide information to patients and the public.
- Process referrals and submit medical records to insurers.
- Verify patient insurance eligibility and benefits.
- Request, track, follow up on, and obtain authorizations before services are provided.
- Manage referral repositories, including EHR buckets, provider email, faxes, the authorization inbox, and Teams message groups.
- Document and communicate patient correspondence and messages in the EMR.
- Use ICD-10 and CPT coding knowledge in daily work.
- Meet productivity and quality targets.
- Review authorization details for accuracy and completeness.
- Prioritize authorization work according to patient urgency.
- Update insurance, contact information, and demographic data in the EHR.
- Monitor insurance changes that affect coverage and authorization requirements.
- Assist with appeals for denied authorizations.
- Update patient records and registration information.
- Respond to patient questions by phone and email.
- Research information using available resources.
- Resolve or escalate patient complaints and urgent or emergent questions.
- Direct calls to the appropriate resources.
- Follow up with patients and callers within departmental timeframes.
- Document communications in accordance with standard operating procedures.
- Answer Wayne Health calls and support team operations.
Талаптар
- High school diploma or equivalent.
- Two to three years of experience in insurance, medical prior authorization, billing, or a physician office.
- Working knowledge of ICD-10 and CPT codes.
- Ability to stay organized while working across multiple screens and browser windows.
- Proficiency with Microsoft Outlook, Teams, Word, and Excel.
- Intermediate knowledge of medical terminology.
- Basic office skills, including typing 35 words per minute and accurate alphanumeric data entry.
- Strong verbal, written communication, and problem-solving skills.
- Interpersonal skills to build productive relationships with physicians, patients, families, and others inside and outside the clinical practice.
- Strong customer service skills, with independent judgment and creativity in resolving customer concerns.
- Careful attention to documentation and communication details.
- Ability to work effectively both independently and as part of a team.
- Ability to manage multiple tasks as priorities change.
- Knowledge of medical insurance and medical office billing.
- Experience navigating EHR, NextGen, or athenahealth systems preferred.
- Ability to sit or stand for extended periods and lift up to 50 pounds.
- Sensitivity when working with seriously ill patients and their families.
- Compliance with department health and safety policies and procedures.
Артықшылықтар
- Full-time schedule of 40 hours per week.
- Additional hours may be required.
- Equal opportunity, affirmative action, veteran, and disability employer.
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