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Reporting: Generate reports detailing referral and authorization metrics, encompassing turnaround times, approval rates, and any pending cases. Attention to Detail: A keen eye for detail is essential to ensure the accuracy of referral and authorization processes.
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Additional college coursework in healthcare administration or related fields is advantageous. Technical Proficiency: Proficient in using computer systems and software, particularly Microsoft Office and relevant healthcare management applications.
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Experience: 1+ year of experience in referral and authorization coordination within the healthcare or managed care sector. The Healthcare Access Coordinator is responsible for efficiently managing the access to healthcare services for our members.
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Regulatory Compliance: Stay updated on pertinent laws, regulations, and policies concerning referrals and authorizations. Quality Control: Conduct regular audits of the referral and authorization processes to identify avenues for improvement.
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The Coordinator will ensure the precise processing of referrals and authorizations, all in alignment with our organization's policies and regulatory standards. Guarantee the completeness, accuracy, and currency of documentation.
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Implement best practices to enhance efficiency and precision. Authorization Handling: Initiate and oversee the authorization procedure, including the acquisition of necessary documentation and approvals.
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As a Healthcare Access Coordinator, you will play a crucial role in ensuring our members promptly receive the services they require. We are dedicated to delivering accessible, high-quality care tailored to the unique needs of our communities.
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Training: Facilitate the training of new team members and providers on referral and authorization procedures. Verify member eligibility and coverage to ascertain authorization needs. Problem-Solving: Effective problem-solving skills to address issues and discrepancies.
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Documentation: Maintain meticulous records of all referrals and authorizations within our system. Our organization is committed to enhancing the healthcare journey for our members. This role entails close collaboration with healthcare providers, members, and internal teams to facilitate the approval of medical services.
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Access Management: Efficiently process referrals from healthcare providers, ensuring completeness and accuracy. Adaptability: Ability to adapt to changes in policies and procedures. Team Player: Collaborative and willing to work as part of a team to achieve shared objectives.
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Engage with providers to gather additional information when necessary. Organizational Aptitude: Excellent organizational and time-management skills for managing multiple referrals and authorizations simultaneously.
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Effective Communication: Collaborate with healthcare providers, members, and internal teams to ensure the timely approval of medical services. Communicate authorization determinations to relevant parties.
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Communication Skills: Strong verbal and written communication skills, with the ability to interact professionally with providers and internal teams. Job Title: Healthcare Access Coordinator. Education: High school diploma or equivalent.
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Experience Required: 1+ Years of Relevant Experience. Escalate intricate cases when needed. Work Arrangement: 100% Remote. Pay: Competitive hourly rate. Location: Northern Virginia. Ensure adherence to these requirements across all processes.
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Issue Resolution: Address and resolve concerns or disparities related to referrals and authorizations.
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