Referral- Auth Eligibility Coordinator

Industry: Healthcare

Location: Remote

Welcome to PINNACLE! Pinnacle Healthcare Revenue Solutions (PHRS) is a full Revenue Cycle Management (RCM) company focused on professional billing for independent physician practices. PHRS is a division of Pinnacle Healthcare, a growing healthcare consulting company based in Colorado with regional offices in St. Louis, Missouri, Indianapolis, Indiana, Phoenix, AZ and remote employees in 21 states. We offer our employees a GREAT team environment, wonderful camaraderie among the team members, and a true appreciation and recognition for hard work.

Summary

Under the direction of the Referral-Eligibility Manager and Senior Eligibility Coordinator will obtain patients Eligibility, Referrals, Authorization updated and correct patient information. This position will utilize the billing software reports to obtain patient information. The position 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, auth’s as required.
• Utilizes insurance websites, and phone calls daily.
• Verify demographic and insurance information and update accordingly.
• Generates billing software reports daily.
• Reviews and updates 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 & 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, 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: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Experience

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

The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor.

Competitive 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 thru MetLife (AD&D; Cancer Care; Hospitalization)

Compensation: $18.00 – $22.00/hr