Job Details:

Job Summary:

The Authorization and Referral Management Representative is responsible for obtaining timely and accurate authorizations for all Hospital services where needed and to ensure that the appropriate referrals are received prior to service. In addition, the Authorization and Referral Management Representative monitors authorization units and ensures that patients don’t exceed authorization limits.

Responsibilities:

• Ensures prior authorizations are obtained from payers on a daily basis based on designated assignment. Learns the specified work flow for other service areas to provide coverage for other Authorization and Referral Management Staff. Cross-trains to learn Community Wide Scheduling Representative position.
• Reviews and resolves on a daily basis pending authorization issues and immediately notifies supervisor of any pending authorization issues interfering with patient services. Assists other Patient Access staff to complete individual workloads.
• Analyzes daily work flow output from the use of productivity reports to ensure accuracy and immediately notifies supervisor of any pending authorization issues interfering with patient services.
• Performs other related duties as assigned.

Experience:

A minimum of one year of experience in a of Patient Access/Registration experience.

Education:

High school graduate or equivalent.

Licenses/Certifications:

None

Other:

• If applicable, the individual performing this job may reasonably anticipate coming into contact with human blood and other potentially infectious materials. Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.
• Must possess excellent communication skills and the ability to conduct themselves in a professional manner at all times.
• Must have good problem solving skills and the ability to know when to seek assistance to ensure positive customer relations.

About Us:

MidHudson Regional Hospital

MidHudson Regional Hospital in Poughkeepsie, NY, is home to the mid-Hudson Valley’s most advanced healthcare services. This 243-bed facility cares for more than 10,000 inpatients annually while performing an additional 325,000 outpatient procedures each year. MidHudson Regional Hospital operates the area’s only Level II trauma center, is home to the Redl Center for Cancer Care and Center for Robotic Surgery, and is a destination hospital for patients with serious illnesses and injuries.