[Hiring] Referral- Auth Eligibility Coordinator @Pinnacle Healthcare Consulting LLC

Role Description

Under the direction of the Referral-Eligibility Manager and Senior Eligibility Coordinator, the Referral/Eligibility Coordinator will obtain patients' eligibility, referrals, and authorization, updating and correcting patient information. This position will utilize billing software reports to obtain patient information and requires updating all demographic and insurance verification information into the practice management system to allow for prompt insurance billing and collections.

Essential Duties and Responsibilities

• Obtain accurate demographic and insurance information, referrals, and authorizations as required.
• Utilize insurance websites and phone calls daily.
• Verify demographic and insurance information and update accordingly.
• Generate billing software reports daily.
• Review and update patients’ files.

Problem Solving

• Identifies and resolves problems in a timely manner.
• Gathers and analyzes information skillfully.
• Develops alternative solutions.
• Works well in group problem-solving situations.
• Uses reason even when dealing with emotional topics.

Customer Service

• Manages difficult or emotional customer situations.
• Responds promptly to customer needs.
• Solicits customer feedback to improve service.
• Responds to requests for service and assistance.
• Meets commitments.

Oral Communication

• Speaks clearly and persuasively in positive or negative situations.
• Listens and gets clarification.
• Responds well to questions.
• Demonstrates group presentation skills.
• Participates in meetings.

Teamwork

• Balances team and individual responsibilities.
• Exhibits objectivity and openness to others' views.
• Gives and welcomes feedback.
• Contributes to building a positive team spirit.
• Puts success of team above own interests.
• Able to build morale and group commitments to goals and objectives.
• Supports everyone's efforts to succeed.
• Recognizes accomplishments of other team members.

Strategic Thinking

• Develops strategies to achieve organizational goals.
• Understands organization's strengths and weaknesses.
• Analyzes market and competition.
• Identifies external threats and opportunities.
• Adapts strategy to changing conditions.

Adaptability

• Adapts to changes in the work environment.
• Manages competing demands.
• Changes approach or method to best fit the situation.
• Able to deal with frequent change, delays, or unexpected events.

Attendance/Punctuality

• Is consistently at work and on time.
• Ensures work responsibilities are covered when absent.
• Arrives at meetings and appointments on time.

Dependability

• Follows instructions and responds to management direction.
• Takes responsibility for own actions.
• Keeps commitments.
• Commits to long hours of work when necessary to reach goals.
• Completes tasks on time or notifies appropriate person with an alternate plan.

Judgment

• Displays willingness to make decisions.
• Exhibits sound and accurate judgment.
• Supports and explains reasoning for decisions.
• Includes appropriate people in decision-making process.
• Makes timely decisions.

Motivation

• Sets and achieves challenging goals.
• Demonstrates persistence and overcomes obstacles.
• Measures self against standard of excellence.
• Takes calculated risks to accomplish goals.

Planning/Organizing

• Prioritizes and plans work activities.
• Uses time efficiently.
• Plans for additional resources.
• Sets goals and objectives.
• Organizes or schedules other people and their tasks.
• Develops realistic action plans.

Qualifications

• Six months to one year related experience and/or training; or equivalent combination of education and experience.

Benefits

• Medical, Dental, Vision, LTD, Life Insurance Group Plans.
• 401K with Safe Harbor Match.
• HSA plan option with employer contribution.
• FSA (healthcare and dependent care) options.
• Voluntary benefits through MetLife (AD&D Cancer Care; Hospitalization).