Prior Authorization Referral Assistant or Trainee- Ottumwa

Summary:

The Prior Authorization Referral Assistant is responsible for submitting prior authorization requests to insurance companies for radiology procedures and ensuring timely follow-up on patient referrals. This position collaborates closely with ordering providers, patients, and external service providers to gather necessary clinical information, submit documentation, and track authorization status.

The role ensures patients receive timely and appropriate care by coordinating referrals, monitoring follow-up activities, and maintaining accurate documentation in the electronic medical record. This position supports quality patient care by facilitating communication between healthcare teams and external partners while maintaining compliance with organizational policies and regulatory standards.

MINIMUM QUALIFICATIONS:

Education:

1.

High school diploma or equivalent required.

Knowledge, Skills and Abilities:

1.

Basic computer skills and familiarity with electronic health records (EHR).

2.

Ability to understand and interpret medical terminology.

3.

Strong organizational skills with attention to detail.

4.

Ability to prioritize tasks and manage multiple referrals simultaneously.

5.

Effective communication skills with patients, providers, and insurance companies.

6.

Strong interpersonal skills and ability to interact with diverse populations in a professional and welcoming manner.

7.

Ability to process information quickly and accurately in a fast-paced environment.

8.

Certification in Basic Life Support (BLS).

Key Responsibilities:

Prepare and submit prior authorization requests with accurate patient and clinical information.

Monitor authorization status and communicate updates with providers and insurance companies.

Address denied requests by identifying issues and coordinating resubmissions when appropriate.

Maintain detailed and accurate documentation of all authorization and referral activities.

Follow up with patients and specialty providers to ensure appointments are scheduled and completed.

Document all communications and referral outcomes in the electronic medical record.

Verify receipt of consultation records to complete referral processes.

Maintain confidentiality and comply with HIPAA regulations.

Provide excellent customer service to patients and healthcare partners.

Participate in quality improvement initiatives and team collaboration efforts.

Hours:

Monday through Friday, daytime hours. Scheduling is subject to change.

Supervisor:

Clinic Manager

Deadline:

Position will remain open until a pool of qualified applicants is received.

Send resume to: recruiting@riverhillshealth.org Or mail to:

River Hills CHC PO Box 458 Ottumwa, Iowa 52501

River Hills CHC offers a competitive wage and full benefit package.

Work Location: In person