Manager Prior Authorization Jobs in Rochester, NY

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Job Location (Full Address):

220 Hutchison Rd, Rochester, New York, United States of America, 14620

Opening:

Worker Subtype:

Regular

Time Type:

Full time

Scheduled Weekly Hours:

40

Department:

400140 Surgery Central Administration

Work Shift:

UR - Day (United States of America)

Range:

UR URCA 205 H

Compensation Range:

$20.30 - $27.41

Responsibilities:

The Department of Surgery float position will provide critical support to patient care areas in the event of absences, vacancies, and unexpected work volume increases. The Physician Support Representative (PSR) float will perform complex secretarial and administrative duties in a variety of clinical areas (ambulatory office practices) with minimal direction and considerable latitude for independent judgment. The float PSR will receive training in all of Surgery's ambulatory practice areas and will have access to eRecord and other systems enabling them to receive and check in patients for their clinic appointments; complete prior authorizations, prepare clinics; manage providers' time and calendars; optimize provider patient schedules; coordinate patient care and information/data support.
The float PSR will require a high level of independence and a broad-based knowledge and skillset to move seamlessly across various divisions and roles. The duties and amount of effort spent on each will vary based on the needs of the assigned area. The float PSR will provide coverage in the Department of Surgery, including but not limited to the following locations: Divisional Offices at Medical Center, Sawgrass 160 & 180 Clinic Locations, Surgery Outpatient Clinics (ACF), Strong West, Vascular Surgery at Highland, Westfall, and/or Canal View

ESSENTIAL FUNCTIONS

• Schedules appointments, tests and surgeries using hospital's information system. Coordinates ancillary appointments, tests and consults in preparation for surgery or further clinical workup. Completes any correspondence or forms involved with appointment scheduling, schedules interpreters and other outside services to meet patient's needs (i.e., transportation). Ensures patient satisfaction with visit prior to discharge from the department. Obtains prior authorizations as needed for procedures and surgeries. Enters surgeries into Op-Time system and coordinates with appropriate operating rooms. Manages the intake of new referrals through various sources including eRecord, work queue, faxed referrals and phone calls from outside providers.
• Appropriately answers and triages incoming phone calls. Evaluates patient's concerns and refers to physicians or other health care personnel to address. Responds to callers independently and follow-up to be sure all requests are handled in a timely fashion. Communicates medical information to patients and messages to other callers as directed by physicians, nurses and administrative staff.
• Collects and updates patient demographic and financial information in an efficient and customer-oriented manner. Utilizes data to complete prior authorizations for services as indicated.Pulls schedules for each clinic day to verify valid insurance. Asks specific questions of patient to verify the accuracy of information to ensure a billable account is established.
• Serves as primary contact for provider(s). Manages provider(s) calendar, prioritizes appointments and meetings based on provider preferences. Chooses and recommends among competing demands. Examines the clinical schedule(s) and administrative schedule on a continuous basis ensuring accuracy and reports problems to the supervisor. Arranges travel, conference registration and hotel accommodations. Manages all incoming mail for surgeon(s) and nurse practitioner(s) assuring that all correspondence receives timely attention and is followed up appropriately. Performs miscellaneous tasks as assigned by the Supervisor.
• Greets patients and initiates a positive ambulatory experience for each patient. Identifies healthcare provider to be seen, directs patient to next destination, obtains signatures as needed (i.e. for insurance forms), identifies and takes steps to meet patients' special needs (i.e. interpreters), monitors reception/waiting area to ensure patients' needs are met and long waits are avoided wherever possible. Collects co-pays at the time of check-in registration. Ensures proper forms are provided to the patient and provides assistance as needed to ensure completion.
• Other duties as assigned.

MINIMUM EDUCATION & EXPERIENCE

• High School Diploma and 2 years of relevant experience required
• or equivalent combination of education and experience required

KNOWLEDGE, SKILLS AND ABILITIES

• Medical Terminology, experiences with surgical/appointment scheduling software (such as Flowcast), and electronic medical records preferred
• Demonstrated customer relations skills required
• Ability to travel throughout the workday required

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