Referral and Authorization Coordinator ? Multi Specialty

Referral and Authorization Coordinator ? Multi Specialty
Job Number
Full/Part Time
Schedule
Salary
31342718 Full Time Varying schedules between 7am and 5pm $49,277 - $69,844
Position Information

This position will provide a broad array of services for outpatient clinics and serve as the subject matter expert responsible for coordinating the delivery of healthcare services to patients by securing all incoming and outgoing patient authorizations and referrals for healthcare services. For incoming patients to UCR Health - reviews referrals, obtains information, and prepares a file for the physician review to determine whether the patient can be seen in the clinic. For current patients, work with other healthcare entities to ensure proper documentation is obtained and sent to the other entity to facilitate the patient to be seen by other specialists, providers, hospitals, etc. At times, may work in the call center to facilitate clinic and patient operations.

Please Note: This position may be assigned to work remotely and at various UCR Health clinic locations. This position may be required to work different shifts, including evenings, weekends, and holidays. Additionally, this position has multiple openings.

Applicants must have current work authorization when accepting a UCR staff position. Currently, we are unable to sponsor or take over sponsorship of an employment Visa for staff.

As a university employee, you will be required to comply with all applicable University policies and/or collective bargaining agreements, as may be amended from time to time. Federal, state, or local government directives may impose additional requirements.

Education
Experience
Experience
Requirement
A minimum of three (3) years of experience working in a medical environment office role with demonstrated experience of the referral, authorization, and/or patient flow process. Required
Knowledge of healthcare insurance systems, which may include Medi-Cal, MediCare, HMO, PPO, fee for service, county funded coverage, and workers' compensation, sufficient to properly obtain and track authorizations, make patient appointments, make referrals for consultations, diagnostic and ancillary services, coordinate hospital services, complete and submit billing documentation, and explain provisions and requirements to patients. Required
Previous electronic medical records (EMR) experience. Preferred
Prior experience working in a UC Health or combined healthcare/academic setting. Preferred
A minimum of one (1) year of experience working in a multi-specialty setting completing work related to patient eligibility, referrals, and authorizations. Preferred
Special Conditions
Special Condition
Requirement
Overtime Required
Minimum Requirements

Excellent customer service and strong interpersonal skills.
Must demonstrate customer service skills appropriate to the job. Ability to recognize and handle customer complaints. Ability to accurately handle a high volume of work in a fast-paced environment with compassion, patience and positive attitude.
Must possess the ability to multi-task between identifying areas for improving patient relations, ensuring that quality standards are met while providing extensive personalized customer service, and executing patient and operational activities.
Strong oral and written communication skills to effectively communicate with patients of varying ages, diagnosis, and multicultural backgrounds.
Knowledge of pertinent laws, regulations, and guidelines governing medical records, confidentiality, privacy and provisions to others, including HIPAA.
Knowledge of practices and protocols related to medical office procedures (i.e., medical terminology, appointments, medical records, insurance verification, cashiering, billing, etc.)
Knowledge of ICD-9/ICD-10, CPT, and HCPCS coding sufficient to identify services performed; including diagnoses, procedures, and supplies.

Preferred Qualifications

Bilingual skills in English and Spanish.

Additional Information

In the Heart of Inland Southern California, UC Riverside is located on nearly 1,200 acres near Box Springs Mountain in Southern California; the park-like campus provides convenient access to the vibrant and growing Inland region. The campus is a living laboratory for the exploration of issues critical to growing communities' air, water, energy, transportation, politics, the arts, history, and culture. UCR gives every student, faculty and staff member the resources to explore, engage, imagine and excel.

UC Riverside is recognized as one of the most ethnically diverse research universities in the country boasting several key rankings of which we are extremely proud.

• UC Riverside is proud to be ranked No. 12 among all U.S. universities, according to Money Magazine's 2020 rankings, and among the top 1 percent of universities worldwide, according to the 2019-20 Center for World University rankings.
  


• UC Riverside is the top university in the United States for social mobility. - U.S. News 2020
  


• UCR is a member of the University Innovation Alliance, the leading national coalition of public research universities committed to improving student success for low-income, first-generation, and students of color.
  


• Among top-tier universities, UC Riverside ranks No. 2 in financial aid. - Business Insider 2019
  


• Ranked No. 2 in the world for research, UCR's Department of Entomology maintains one of the largest collections of insect specimens the nation. - Center for World University Rankings
  


• UCR's distinguished faculty boasts 2 Nobel Laureates, and 13 members of the National Academies of Science and Medicine.
  

The University of California is an Equal Opportunity/Affirmative Action Employer with a strong institutional commitment to the achievement of excellence and diversity among its faculty and staff. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, or any other characteristic protected by law.

For information about our generous employee benefits package, visit: Employee Benefits Overview

Job Description Details