Referral/Pre Auth Coordinator

Meritas Health is hiring a Pre-Authorization/Referral Coordinator to join our Briarcliff team in the Northland!  If you’re looking for a great opportunity to serve our community and be part of a growing organization, join our Meritas team!

Here at Meritas our mission is to provide hope and healing to every life we touch.  Whether you are serving patients at a primary care practice, specialty practice, or in a support capacity, every team member works together to complete this mission.  Joining Meritas means you are joining a family that is committed to serving our community and giving patients better quality of life. 

Reasons to Join Meritas:

• Comprehensive Benefits (Medical, Dental, Vision, Life, FSA)
• Employer match retirement plan
• Competitive wages
• Paid time off for personal/vacation/sick
• Six paid holidays per year
• Educational assistance
• Day shift schedules

Job Description:

Under the direction of the Practice Manager or Supervisor, Patient Services, this position is responsible for coordinating and ensuring referrals and/or pre-authorizations are managed and addressed appropriately.  Works collaboratively with the health care team and the patient to schedule referral appointments, and independently completes the process for required pre-certification and prior authorizations in a timely manner.

Job Duties:

•   Provides quality service by acting as a liaison between healthcare team, patient and specialists to coordinate outpatient referrals and obtain pre-certifications or prior authorizations as necessary.  
• Utilizes the EMR system to its full potential in capturing the necessary information needed for making an appointment and communicating necessary information such as referral requirements, patient demographic information, insurance and approval information, and comments about specific patient information key to a successful appointment.
• Provides education to patients about the importance of the referral process and service provided by the physician’s office, which may include subspecialty focus. 
• Coordinates efforts between providers, gathering and providing information key to appointment success.
• Communicates to physicians and other health care providers the various requirements and processes involved with medical referral authorizations for the most expedient patient appointment and successful visit.
• Completes the referral and/or preauthorization process by ensuring the specialists’ report or test results are received.
• Notifies the referring physician when a patient does not keep a referral appointment or a pre-authorization is denied.
• Monitors incoming patient paperwork to be scanned and flags results that are to be reviewed by the physician.
• Completes FMLA, ADA and other medical paperwork as directed by the physician.

Minimum Requirements:

• High school graduate or GED
• Minimum two years of experience in a physician office preferred.
• Working knowledge of medical terminology and knowledge of various insurance company requirements for pre-certification and referrals.
• Basic office skills, critical thinking, detail oriented and able to multitask in a fast paced environment.

More Possibilities:

As the largest network of providers in the Northland, we can offer you more opportunities to grow. Here at Meritas, we believe that together, we will become legendary for our commitment to remarkable patient care. If you are looking to better the lives of those in our community, then join our Meritas family, where your voice counts.

Meritas Health is an Equal Opportunity Employer and values diversity in our organization. We do not discriminate against any applicant for employment or employee on the basis of race, color, religion, gender, age, marital status, sexual orientation, national origin, disability, veteran status or any other classification protected by applicable discrimination laws. Meritas Health is a drug free workplace and conducts post-offer/pre-employment drug screens and background screens.