Central Referral/Prior Authorization Specialist

MaineHealth | Damariscotta, ME

Posted Date 3/13/2019
  • Position Summary
    • This position will complete referrals and pre-certifications generated from LincolnHealth physician practices based on the given insurance. This position will work closely with all physician practices, fiscal services, radiology and other hospital departments as necessary. This position will call patients and verify appointment status with Specialist and patients as necessary. This position will review all admissions for pre-certification; this includes all scheduled CT scans, nuclear medicine exams, procedures, surgeries and emergency admissions.
  • Required Minimum Knowledge, Skills, and Abilities (KSAs)
    • High School diploma.
    • 3+ years of experience in hospital billing and/or physician practice setting, preferred.
    • Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations.
    • Ability to add and subtract two digit numbers. Ability to perform operations using units of American money and weight measurements, volume and distance.
    • Ability to solve practical problems and deal with a variety of variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form.

**This position also supports the Community Paramedicine program (a collaboration with local EMS groups to provide at-home care) as needed.**

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