Physician Liaison

PHYSICIAN LIAISON – AHMC Health Care

Primary purpose of this position is to ensure that appropriate authorization and reimbursement resources are in place for elective services provided.

• Verification of order received from physician and verification of insurance information provided.
• Accurate and timely determination of authorizations required.
• Validate that required authorizations are obtained and monitored for appropriateness of the procedure.
• Adherence to government and non‑government program requirements.
• Effectively communicate with Scheduling and Patient Access the authorization/program requirements for their elective procedure, personal payment liabilities if known, and options for care and placement that allow for informed decisions by the patient and his/her family while protecting the financial interest of Seton Medical Center.
• Provide information to Scheduling and Patient Access when authorizations are delayed, denied for rescheduling procedures when no other options are available.

• Demonstrated expertise in insurance authorization confirmation and follow‑up.
• Demonstrated knowledge of Patient Access, Medical Records, and related departments and their impact on reimbursement.
• Ability to work well with a variety of positions, including physicians, nurses, Patient Access and Patient Financial Services staff.
• Proficient with Microsoft Office Suite, AS400 applications, and database management.
• Ability to utilize software applications to maximize automation and efficiency.
• Able to learn new software applications and/or programs as needed.

Minimum of 1 year experience working with Commercial Insurance, Medi‑Cal and Medicare insurance verification, pre‑authorizations and authorizations preferred.

• Seniority level:
  Entry level
• Employment type:
  
  Full‑time
• Job function:
  Health Care Provider