About The Position

Nestled between Burbank and Pasadena, Adventist Health Glendale is one of the area's leading healthcare providers. We are comprised of a 515-bed hospital, two urgent cares, home care services, comprehensive cardiology care and a vast scope of services located in the San Fernando Valley. We are committed to the development and empowerment of our nurses and have received Magnet designation from the American Nurses Credentialing Center. Glendale is known for its urban living, with easy access to dining, entertainment, shopping, amusement parks and outdoor recreation. Adventist Health Glendale is proud to be part of the thriving, diverse community since 1905. Job Summary: Supervises ongoing tracking and appropriate documentation for referrals. Ensures complete and accurate registration, including patient demographic and current insurance information. Assures the timely and efficient response to consultations/referrals that are both local and regional. Oversees central scheduling operations to ensure coordinated, efficient, and patient-centered scheduling of appointments, procedures, and follow-up visits across multiple departments and specialties. Ensures adherence to scheduling protocols, optimizes provider availability, and monitors appointment access metrics. Provides oversight and direction to the authorization team, ensuring timely and accurate verification of insurance authorizations for procedures, treatments, and services. Ensures that the authorization process is compliant with insurance regulations and institutional policies, and that all necessary documentation is obtained to prevent delays in patient care. Supervises and directs the activities of various levels of assigned personnel using both professional and supervisory discretion and independent judgment.

Requirements

  • Bachelor’s Degree or equivalent combination of education/related experience: Required

Nice To Haves

  • Master's Degree
  • Five years' relevant healthcare experience
  • Three years' clinical experience
  • Licensed health care provider

Responsibilities

  • Obtains and reviews relevant information and determines the optimal placement for the patient within the organization. Communicates the recommendation to the referring physician, patient, family, and referral coordinator or discharge planner. Contacts review organizations and insurance companies to ensure prior approval requirements are met
  • Presents necessary medical information such as history, diagnosis and prognosis. Provides specific medical information to financial services to maximize reimbursement to the hospital and physicians Acts a point of contact for patient and families.
  • Assists patients in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance). Assumes advocate role of on the patient's behalf with the carrier to ensure approval of necessary supplies/services.
  • Supervises timely and accurate verification of insurance authorizations for all procedures, treatments, and services. Works closely with the team to ensure all necessary documentation is obtained to prevent delays in patient care and that the authorization process is in compliance with insurance regulations and institutional policies.
  • Oversees the efficient and timely coordination of appointments, procedures, and follow-up visits. Ensures that scheduling protocols are followed, that provider availability is optimized, and that appointment access meets the needs of patients, referring physicians, and service providers.
  • Performs other job-related duties as assigned.
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