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Wayne State University Physician Group (UPG)
Wayne State University Physician Group (UPG)
1.001 – 5.000 Angajați
Asistență medicalăEducațieNonprofit
Wayne State University Physician Group (UPG) este o organizație medicală academică nonprofit cu sediul în Detroit, care oferă servicii pacienților din sud-estul statului Michigan. Echipa sa, formată din peste 400 de medici și furnizori de servicii medicale avansate, asigură îngrijire primară și de specialitate în aproximativ 50 de domenii medicale, cu sprijinul clinicilor multispecializate și unispecializate, al unităților mobile de sănătate și al inițiativelor de sănătate comunitară. Prin legătura sa cu Wayne State University School of Medicine, UPG contribuie, de asemenea, la educația medicală și cercetarea clinică, în timp ce programe precum Center for Population Health Accountability abordează factorii medicali, comportamentali și sociali care influențează sănătatea comunității.
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Locurile de muncă ale companiei

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.

USStatele Unite ale AmericiiMIMichiganRemoteNormă întreagăJuniorNivel mediuNu este necesară o diplomăLimbă Obligatorie: englezăCoordonator de recomandăriGeneral

Descriere

  • 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.

Cerințe

  • 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.

Beneficii

  • 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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