Job description

Responsibilities

GENERAL PURPOSE:
Primarily responsible for scheduling and oversight of Prior Authorization and Referral Coordination for all Endoscopy scheduling for the Division of Colorectal Surgery across all UR Medicine locations. Trains new staff. Resolves problems and issues. Monitors quality assurance of daily operations. Provides coaching and training support.

JOB DUTIES AND RESPONSIBILITIES:

• Receives incoming patient telephone calls for surgeon(s) and nurse practitioner(s), managing and/or resolving various scheduling/coordination issues and answering questions as needed. Coordinate scheduling of patients at multiple practice sites; coordinates referrals for consults. Obtains patient medical records to facilitate patient care. Documents telephone calls into eRecord. Triages telephone calls from patients and referring physicians to surgeons, residents and nurse practitioners. Has a focused understanding of all available surgical location options across the UR Medicine Hospitals affiliates and schedules Endoscopy procedures at the best location for the patient.
• Serves as point of contact to schedule, obtain prior authorizations, answer questions and solve problems for difficult and unusual authorizations and referrals. Assists in problem identification, quantification and resolution. Assumes responsibility for recall letters and two-week reminder calls.
• Provides training and expertise for Prior Authorization and Referral Coordinator for all Endoscopy procedures on all aspects of referral work, including electronic medical system support, missing referral queue, patient record review, appointment and/or ancillary test scheduling, procedural scheduling, knowledge of provider sub-specialties and collection of additional information from provider or electronic medical system to submit to insurance carrier when needed. Is responsible for building, maintaining and updating templates as needed.
• Performs quality assurance monitoring for activities in area of immediate responsibility and other areas that affect it utilizing specific criteria. Measures quality, quantity and timeliness of tasks performed. Prepares related logs and management reports.
• Implements and monitors departmental/office specific procedures, to work in conjunction with enterprise established processes, for enhancing levels of service and quality. Develops departmental/office guidelines for prioritizing and assigning work activities working with the Divisional administrators, evaluates effectiveness and modifies processes as necessary.
• Collaborates with other Prior Authorization and Referral Coordinator Leads across programs to establish best practice standards. Disseminates those standards and implements and monitors the adherence to those standards.
• Acts as resource for information. Attends educational programs for department at the direction of supervisor. Educates other staff on materials.
• Other duties as assigned

QUALIFICATIONS:

• High School Diploma required
• 2 years of relevant experience, including 1 year of demonstrated leadership required
• or equivalent combination of education and experience required
• Medical terminology preferred
• Surgical/appointment scheduling software, such as Cadence and OpTime preferred.
• Electronic medical records preferred

The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University’s mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.

Job Type: Full-time

Pay: $19.00 - $21.50 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Professional development assistance
• Retirement plan
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Day shift

Ability to commute/relocate:

• Rochester, NY 14642: Reliably commute or planning to relocate before starting work (Required)

Education:

• High school or equivalent (Required)

Experience:

• Insurance verification: 1 year (Preferred)
• Medical billing: 1 year (Preferred)
• Medical office: 2 years (Preferred)

Work Location: In person

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