Prior Auth/Ref. Spec- GFP

About Us

Lifepoint Health’s Central Kentucky market is comprised of four acute care, community-based hospitals, with over 50 outpatient clinics that provide comprehensive healthcare in the Bluegrass region.Bluegrass Community Hospital(Versailles, KY),Bourbon Community Hospital(Paris, KY),Clark Regional Medical Center(Winchester, KY), andGeorgetown Community Hospital(Georgetown, KY) are committed to our mission of making communities healthier. As an integrated network, our facilities have the ability and resources to develop opportunities for professional growth and advancement to accomplish your career goals. We take pride in personalized patient care backed by high-quality designations to support a culture of safety for both employees and patients. Get back to the heart of your community by caring for your neighbors — join our team today!

A Career with Us Offers:

· Newly Adjusted Competitive Pay Rates

· Paid Time Off (PTO)

· Extended Illness Benefit (EIB)

· Flexible Spending Accounts (FSA)

· Choice of Insurance Plans (Health, Dental, Vision, Life)

· Educational Assistance

· Bereavement Leave

· 401(k) Match

· Free Parking

Essential Functions

Requires excellence in customer service and telephone etiquette. Must be able to participate in receiving phone calls via a department telephone queue.

Uses clinical knowledge to receive orders for review and clarification when needed, including medical necessity checking for all Medicare patients. Ensure complete and accurate registration, including patient demographic and current insurance information.

Review details and expectations about the referral with patients.

Ensure that referrals are addressed in a timely manner.

Must show a basic facility with insurance benefits, coverage verification, and network access, coordination of benefits (COB), payment calculation, and referral requirements.

Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety. Utilize P2P when applicable.

Communicates lag time and/or delays in scheduling to the patient. Completes follow up in a timely manner via telephone and/or mail.

Job Requirements

Minimum EducationHigh School Diploma or equivalent preferred
Associate’s Degree Preferred

Required SkillsRequires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.

Minimum Work ExperienceMinimum 3 years experience in healthcare environment or in leadership/management position.

Job: Billing/Collections

Organization: Georgetown KY MSO

Title: Prior Auth/Ref. Spec- GFP

Location: Kentucky-Georgetown

Requisition ID: 7427-5052