Referral Authorization Specialist - SVMG
Company: Canyon Vista Medical Center
Location: Sierra Vista
Posted on: November 18, 2023
Who We Are:People are our passion and purpose. Come work where
you are appreciated for who you are not just what you can do.
Canyon Vista Medical Center is a 106 bed Joint Commission
Accredited offering a number of specialty services. We are proud to
serve our community with a Level III Trauma unit, Center of
Excellence for Total Joint Replacement, Level I Nursery, American
College of Radiology Accredited Facility, as well as many other
state of the art services to ensure our patients are cared
for.Where We Are:Sierra Vista, Arizona is a flourishing city
located 75 miles southeast of Tucson. Thanks to our year-round
temperate climate, affordable housing, low cost of living, access
to healthcare and education facilities, not to mention the
breathtaking natural beauty of majestic mountain ranges and the San
Pedro River and outdoor activities, Cochise County residents enjoy
an excellent quality of life.Why Choose Us:
- Health (Medical, Dental, Vision) and 401K Benefits for
- Competitive Paid Time Off / Extended Illness Bank package for
- Employee Assistance Program mental, physical, and financial
- Tuition Reimbursement/Assistance for qualified applicants
- And much morePosition Summary:The Referral/Authorization
Specialist is responsible for servicing the needs of members,
providers, and the Health Plans representatives. Obtains referral
authorization from insurance carriers and relays such
authorizations (or denials) to the patient and the provider. Carry
out provider orders, such as standing orders and referrals.
Verifies procedure codes are accurate on orders before sending.
Resolves all pre-authorization, registration, or other
referral-related issues prior to a patient's appointment.
Upload/prepare for upload patient portal documents, including test
results, visit summaries, etc. Assist with phones as
necessary.Verifies members eligibility and benefits with subsequent
notification to designated staff of eligibility issues. Notifies
required parties within the appropriate timeframe for routine and
urgent requests for services. May process/coordinate medical
records requests.Complete orders for additional services based on
notes from provider, finishing these tasks within the Electronic
Medical Records (EMR) Athena Net.Understand those insurance plans
which require prior authorizations for services and relay
information to providers/patients as necessary.Ensure length of
referral/number of visits is properly documented within Athena Net.
All other duties as assigned.Minimum Qualifications:
- High School Diploma or G.E.D preferred.
- 1 to 2 years of experience preferred.EEOC Statement:Canyon
Vista Medical Center is committed to providing Equal Employment
Opportunities for all applicants and employees and complies with
all applicable laws prohibiting discrimination against any employee
or applicant for employment because of color, race, sex, age,
religion, national origin, disability, genetic information, gender
identity, sexual orientation, veterans' status or any other basis
protected by applicable federal, state or local law.
Keywords: Canyon Vista Medical Center, Sierra Vista , Referral Authorization Specialist - SVMG, Other , Sierra Vista, Arizona
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