Centralized Authorization & Referral Manager

Centralized Authorization & Referral Manager

Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years! We are one of central Texas' largest professional medical groups with 35+ locations and we are continuing to grow. We offer the following benefits to eligible team members : Medical, Dental, Vision, Flexible Spending Accounts, PTO, 401(k), EAP, Life Insurance, Long Term Disability, Tuition Reimbursement, Child Care Assistance, Health & Fitness, Sick Child Care Assistance, Development and more.

Under general supervision of the Associate Director of Centralized Operations, the Centralized Authorization and Referral Manager supports patient care by ensuring the timely and adequately processing of referrals and authorizations. Institutes changes and updates workflows as necessary as a response to insurance, healthcare, and organizational changes. Duties also include but are not limited to hiring, coaching, motivating, staffing, evaluating, and training staff. Carries out all duties while maintaining compliance and confidentiality and promoting the mission and philosophy of the organization.

Essential Functions

• Supports patient care by ensuring the timely and adequately processing of referrals and authorizations.
• Institutes changes and updates workflows as necessary as a response to insurance, healthcare, and organizational changes.
• Supervises authorization and referral staff. Ensures adequate staffing. In collaboration with resource departments, responsibilities include hiring, motivating, evaluating, disciplinary actions, staff training and development, promoting teamwork and fostering a positive work environment.
• Keeps up to date with insurance and referral requirements.
• Ensures teams are adhering to departmental guidelines and operational expectations.
• Updates and maintains reporting for department.
• Serves as an escalation point for staff to resolve service, patient and referral process concerns. Assists in resolution for issues.
• Implements improvements to departmental workflows and processes.
• Builds resources and team materials.
• Ensures compliance with ARC standards as well as applicable federal, state, and local laws.
• Meets staffing requirements as determined by the management team, in a manner that effectively and efficiently meets the needs of the organization.
• Builds communication and teamwork by holding regularly scheduled meetings with Supervisors and / or Team Leaders.
• Coordinates with Supervisor and Human Resources to ensure proper counseling or discipline documentation occurs, as appropriate.
• Reviews reports on productivity and quality with Supervisors and / or Team Leaders.
• Collaboratively works between operations and clinic management.
• Assists with development and / or implementation of department-specific policies, procedures, and programs and monitors adherence to system-wide policies / standardizations.
• Attends administrative and executive meetings as necessary to deliver reports and updates regarding the CART team.
• Assists with coverage, training, scheduling, and overall responsibilities as it pertains for Holiday shifts.
• Serves and actively participates on various committees or meetings as a voice for the department.
• Adheres to all company policies, including but not limited to, OSHA, HIPAA, compliance and Code of Conduct.
• Regular and dependable attendance.
• Follows the core competencies set forth by the Company, which are available for review on ARC Sharepoint.

Other Duties and Responsibilities

Qualifications

Education and Experience

Required :

OR

Knowledge, Skills and Abilities

Equal Opportunity Employer