Referral & Prior Auth Lead
Under general direction and with latitude for independent judgment the Lead Referral Coordinator & Prior Authorization Specialist serves as a team Lead for the support services staff in the Therapy Services Patient Access Team. In conjunction with leadership team, the Lead Referral Coordinator & Prior Authorization Specialist promotes operational efficiency, high quality, outstanding patient experience, and strong financial performance.
Patient Access & Prior Authorization (30%)
Performs duties of the team as required for coverage or more complex requests including; appointment scheduling, referral management, and prior authorization.
Subject matter expert for department scheduling and prior authorization workflows
Provides support to clinicians and other teams regarding scheduling and prior authorization related questions/concerns
Provides real time support to Call Center Representatives, Referral Coordinators, and Prior Authorization Specialists; triages and resolves questions and/or complex issues
Communications and coordinates with local Front Office and clinicians
Leads weekly huddles and/or team meetings, including recording and distributing meeting minutes; fosters a cohesive team environment.
Directs staff using the ICARE framework, promoting a collaborative, diverse, and professional team.
Provides feedback to leadership for performance reviews
Acts as primary preceptor for new staff or supports existing staff in implementation of new workflows
Works with Manager to develop and revise training materials and protocols
Attends educational programs for department at direction of supervisor and teaches other staff.
Quality Assurance (10%):
Performs quality assurance monitoring for activities completed in area of immediate responsibility; prepares related logs and management reports.
Continuously evaluates workflows for improvement opportunities
Achieves and maintains proficiency in provision of excellent customer service, accuracy and efficiency of work.
Supports and uphold policies, procedures, objectives, quality improvement, safety, environmental and infection control and codes and requirements of accreditation and financial performance.
Appointment scheduling in an ambulatory or outpatient setting
Call center/customer service experience
Insurance and/or prior authorization experience
1 year in a leadership and/or supervisory role with direct reports
- 2 years of relevant experience, including 1 year of demonstrated leadership or equivalent combination of education and experience.
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.
How To Apply
All applicants must apply online.
EOE Minorities/Females/Protected Veterans/Disabled
Pay Range: $ 19.00 - $ 24.70 Hourly
The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.
Location: Strong Memorial Hospital
Full/Part Time: Full-Time
Opening: Full Time 40 hours Grade 010 Therapy Support Services