Physician Auth/Referral Specialist in Wilmington, DE for Nemours

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Physician Auth/Referral Specialist

Remote Position. Candidates must live in Delaware, New Jersey or Pennsylvania. The Specialist is responsible for obtaining and processing Elective, Urgent, and Emergent referrals and authorizations for physician based services and some office based services, including but not limited to cardiology, audiology test, laboratory testing. The Specialist is also responsible for obtaining genetic testing approval and medication authorizations and other assigned outpatient services. The Specialist will work with partner hospitals for claim submission and registration accuracy. They will also ensure that patient responsibility estimates are created and communicated timely. Elective referrals and authorizations are obtained prior to the s

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