Referral & Prior Authorization Representative IV - Remote

Overview

The Referral & Prior Authorization Representative IV oversees and provides direction to team members, assists in problem resolution, and ensures quality assurance in referral processes within the healthcare setting.

In Short

• Oversee lower level team members and serve as a point of contact for difficult authorizations.
• Train new employees on referral processes and electronic medical systems.
• Monitor quality assurance of daily operations.
• Assist in problem identification, quantification, and resolution.
• Develop departmental guidelines for prioritizing work activities.
• Coordinate daily assignments for lower level staff.
• Participate in recruitment and performance evaluations.
• Manage staff requests for time off and overtime.
• Educate staff on departmental materials.
• Attend educational programs as directed.

Requirements

• High School diploma or equivalent with 3 years of relevant experience.
• 1 year of demonstrated leadership experience.
• Knowledge of medical terminology preferred.
• Experience with surgical/appointment scheduling software preferred.
• Familiarity with electronic medical records preferred.

Benefits

• Opportunity to work in a diverse and inclusive environment.
• Engagement in a mission-driven organization.
• Access to educational programs.
• Support for professional development.
• Competitive compensation within the specified range.