Top 8 Physician liaison Jobs in Middletown, De

Orthopedic Authorization Liaison
Nemours —Wilmington, DE
- Full-time
- 5 years
- Research
- Mid-level
Clinical Liaison SNF
Encore Parkside —Newark, DE
- $75,000 - $85,000 a year
- Full-time
- Skilled nursing facility
- Mid-level
- Organizational skills
- Flexible schedule
Quick Apply
4d
Medical Science Liaison, Rare Hematology, Pacific Northwest (WA, OR, ID, MT, AK)
Alexion Pharmaceuticals,Inc. —Wilmington, DE
- Weekends as needed
- Hybrid work
- Clean driving record
- Medicine
- Office
Billing Liaison Sr/Coder
Nemours —Wilmington, DE
- Full-time
- High school diploma or GED
- Epic
- Senior level
Community Health Worker Liaison: Haitian Creole
Delaware Breast Cancer Coalition —Dover, DE
- $48,000 - $52,000 a year
- Weekends as needed
- Hybrid work
- Writing skills
- Mid-level
- Office
Quick Apply
DFS Liaison / Case Manager
BRANDYWINE COUNSELING & COMMUNITY SERVICES INC —Wilmington, DE
- From $17 an hour
- Weekends as needed
- Addiction Medicine
- Writing skills
- Office
- Health insurance
- Dental insurance
Quick Apply
LPN Home Health Liaison
Christiana Care Health Systems —Wilmington, DE
- $27.31 - $40.96 an hour
- Weekends as needed
- Customer service
- Mid-level
- Driver's License
- Health insurance
- Tuition reimbursement
5h
Consult Liaison Psychiatrist
Christiana Care Health Systems —Newark, DE
- $257,751 - $380,035 a year
- Full-time
- Psychiatry
- BC/BE
- Adults
- Health insurance

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Orthopedic Authorization Liaison

Nemours -
Wilmington, DE

Apply Now

Job Details

Full-time

Qualifications

High school diploma or GED

Full Job Description

Nemours is seeking an Orthopedic Authorization Liaison to join our Nemours Children's Health team in Wilmington, DE.

The Orthopedic Authorization Liaison is responsible for optimizing payment of services by obtaining and processing Elective, Urgent, and Emergent referrals and authorizations for Orthopedic patients with non-participating insurance including but not limited to out-of-state Medicaid plans and commercial insurance plans. The Liaison is also responsible researching and notifying family of co-payment responsibilities. Referrals and authorizations are obtained prior to the date of service. During the referral process the Liaison will partner with the Primary Care Practitioner to obtained required referrals. The Liaison will be a leader in working with outside groups to educate around the referral/auth process. During the authorization and notification process the Liaison will provide the payor with all patient information and requested documentation necessary to obtain admission approval. This role is required to utilize all available resources to verify eligibility, benefit levels, and patient copayment responsibilities.

This position collaborates with: Hospital and Physician Authorization departments, non-Nemours physician offices, managed care department, Nemours Physicians, and Departmental Administrative Staff to ensure that accurate information is collected and distributed effectively and efficiently. The Liaison utilizes daily reports and work queues to complete follow up on non-approved cases and assure completion prior to appointment or admission date according to department standards. In addition, the Liaison will report weekly on payor issues, barriers impacting workflows, and specific issues that could result in a non-reimbursable visit. The Liaison will have the ability to cover all referral and authorization types and demonstrate effective utilization of EPIC applications as indicated by performance measures. This position will also assist with educating the Orthopedic Surgical Coordinators and other clinical and non-clinical team members on high-level processes and act as a resource for the department.

Essential Functions

Ensure timely notification and request for authorization/referrals is handled in accordance with policy and payor requirements.
Maintaining confidentiality, verify patient demographics, insurance eligibility, benefits, and financial responsibility.
Ability to request/obtain authorizations/referrals for Orthopedic patients with non-participating insurance.
Contact families, primary care providers, and other allied health professionals to obtain necessary information and assist with insurance issues preventing authorization/referrals.
Knowledge of participating and non-participating insurances, billing, Epic work queues, insurance authorization requirements, CPT and ICD-10 codes, managed care, utilization management, financial estimates, and medical terminology.
Develop spreadsheets and databases to analyze data, track authorization and denial trends, and report patterns.
Clearly document all communications and contacts with payors and families in standardized documentation requirements including proper format.
Provides back-up to the Access Center Specialist role as needed.

Requirements

High School Diploma or equivalent required; Associate's Degree preferred

Certified Revenue Cycle Representative (CRCR) and/or Certified Healthcare Financial Professional (CHFP) is required

SuperUser certification is preferred

Minimum five years of referral and / or authorization experience is required.

Apply Now

Refine Your Search

physician liaison jobs in middletown, de

Orthopedic Authorization Liaison

Clinical Liaison SNF

Medical Science Liaison, Rare Hematology, Pacific Northwest (WA, OR, ID, MT, AK)

Billing Liaison Sr/Coder

Community Health Worker Liaison: Haitian Creole

DFS Liaison / Case Manager

LPN Home Health Liaison

Consult Liaison Psychiatrist

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