"Alerted.org

**We are more than a health system. We are a belief system.** We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more – in our careers and in our communities.

Job Description Summary:

This position is responsible for processing referral requests for all providers practicing within the clinic module and ensuring that when needed, referral/authorization numbers are obtained for these services. Access to specialty and ancillary testing services is a key component for the treatment of our patients and the satisfaction of our referring providers. The responsibilities of this position are extremely important in meeting or exceeding customer satisfaction.

Responsibilities And Duties:

1. 40 % : Search electronic medical records to obtain the required clinical information needed for medical authorization. Provides all necessary information medical records, scripts, et c to payer. 2. 30 % -Reviews, Obtains & Processes all diagnostic/specialty/miscellaneous referral and authorization requests for both provider and facility. 3. 20 % Handles calls from internal and external sources where prioritization and time sensitive action is required. 4. 10 % -Communicates with all involved, payer, provider, patient as appropriate and as per protocol. Provides a standard of excellence as it relates to customer service and satisfaction for all customers.

Minimum Qualifications:

High School or GED (Required)

Additional Job Description:

The ideal candidate should have the following:

+ Prior experience in obtaining healthcare pre-authorizations

+ Working knowledge of ICD-10 and CPT classification systems

+ Working knowledge of Anatomy & Physiology, and Medical Terminology

+ Experience in a physician practice or hospital setting with patient registration, front desk, and insurance knowledge required

+ Experience with third party payors required

+ Detailed oriented, self-motivated, a continuous learner with an interest in process improvement, and team player

+ Ability to navigate multiple computer screens and browsers quickly and accurately

+ Strong communication skills & professional demeanor

+ Able to learn and work in a remote work setting while maintaining departmental productivity and accuracy standards

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities are subject to change. Other duties may be assigned as needed by leadership based on business need.

Work Shift:

Day

Scheduled Weekly Hours :

40

Department

Corporate Pre Access

Join us!

Equal Employment Opportunity

OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment

Remote Work Disclaimer:

Positions marked as remote are only eligible for work from **Ohio** .