• Job Description

  Req#: 38914

  Who We Are
  JPS Health Network is a $950 million, tax-supported healthcare system in North Texas. Licensed for 582 beds, the network features over 25 locations across Tarrant County, with John Peter Smith Hospital a Level I Trauma Center, Tarrant County's only psychiatric emergency center, and the largest hospital-based family medical residency program in the nation. The health network employs more than 7,200 people.

  Acclaim Multispecialty Group is the medical practice group featuring over 300 providers serving JPS Health Network. Specialties range from primary care to general surgery and trauma. The Acclaim Multispecialty Group formed around a common set of incentives and expectations supporting the operational, financial, and clinical performance
  outcomes of the network. Our goal is to provide high quality, compassionate clinical care for every patient, every time.

  Why JPS?
  We're more than a hospital. We're 7,200 of the most dedicated people you could ever meet. Our goal is to make sure the people of our community get the care they need and deserve. As community stewards, we abide by three Rules of the Road:

  1. Own it. Everyone who wears the JPS badge contributes to our journey to excellence.
  2. Seek joy. Every day, every shift, we celebrate our patients, smile, and emphasize positivity.
  3. Don't be a jerk. Everyone is treated with courtesy and respect. Smiling, laughter, compassion - key components of our everyday experience at JPS.

  When working here, you're surrounded by passion, diversity, and dedication. We look forward to meeting you!

  For more information, visit www.jpshealthnet.org .
  To view all job vacancies, visit www.jpshealthnet.org , www.jpshealthnet.org/careers , or www.teamacclaim.org .

  #supportfeaturedjob

  Job Title:	Referral Authorization Specialist
  Requisition Number:	38914	Employment Type:	Full Time
  Division:	ACCLAIM ADMIN SERVICES	Compensation Type:	Hourly
  Job Category:	Support Services	Hours Worked:
  Location:	John Peter Smith Hospital	Shift Worked:	Day

  
  

  Job Description:

  Description: The Referral Authorization Specialist is responsible for verification of insurance benefits and eligibility prior to submitting for authorization and pre-certification requirements. This position is responsible for scheduling appointments per approved protocols and guidelines as well as assist callers in accessing services and providing general healthcare related information as needed.

  Typical Duties:

  1. Coordinates with medical staff, payers, physicians, and patients regarding authorization status and options.
  
  
  2. Maintains current referral procedures according to payer requirements.
  
  
  3. Oversees inbound, outbound calls and/or review correspondence, documents and other referrals received via fax or email.
  
  
  4. Initiate, follow up, and verify insurance eligibility and benefits for services ordered and document complete information in Epic referral notes.
  
  
  5. Obtains prior authorizations as required by payer, including procurement of needed clinical documentation by collaborating with Clinical Care Team and payer. Obtain all authorizations via web, fax or phone.
  
  
  6. Assist patient with finding resources that accept various insurances, when processing Outgoing/External referrals.
  
  
  7. Determines patient’s financial responsibilities as indicated by payer.
  
  
  8. Configures coordination of benefit information and eligibility on every referral.
  
  
  9. Documents all pertinent communication with patient, physician, and payer.
  
  
  10. Reviews and manages Epic work queues to maintain accurate and timely authorization requests.
  
  
  11. Schedules appointments as appropriate within required timeframes.
  
  
  12. Serves as a resource liaison with referral/appointment inquiries from patients, clinical care teams, and other staff.
  
  
  13. Meets productivity and documentation standards while following planned priorities as set by Patient Access Team Lead and/or Manager.
  
  
  14. Performs other related job duties as assigned.

  Qualifications:

  
  

  Required Education and Experience:
  • High School Diploma or GED equivalent.
  • 1 plus years of progressive responsibilities and direct work related experience.
  • 1 plus year of experience in a Patient Access/Patient Accounting role
  
  Required Licensure/Certification/ Specialized Training:
  • Completion of 90 day and annual competency based registration knowledge and skills assessments.
  • Patient Access – General Consent Orientation and Patient Financial Experience Training (must be completed 30 days subsequent to hire)
  Preferred Licensure/Certification/Specialized Training:
  • Certified Healthcare Access Associate (CHAA)
  • Bilingual in Spanish, Vietnamese, Arabic or other language.

  Location Address:
  1500 S. Main Street
  Fort Worth, Texas, 76104
  United States

• About the company

  Official account for JPS Health Network and John Peter Smith Hospital in Fort Worth. Call 9-1-1 in an emergency. https://t.co/WC3nmODjTC

Notice