About The Position

This position is responsible for processing referral requests for all providers practicing within the clinic module and ensuring that when needed, referral/authorization numbers are obtained for these services.

Requirements

  • 2 years - Diagnosis and Procedural coding - preferred
  • 2 years - Experience in the field or in a related area - required
  • 2 years - Customer service - required
  • 2 years - Third party payers (insurance carriers) using commonly used concepts, practices and procedures in the field - required
  • High School Diploma or GED equivalent - required

Nice To Haves

  • Computer experience - preferred
  • Certificate Medical Terminology - preferred

Responsibilities

  • Attends Referral training class and various referral system training classes within 1st month of employment.
  • Attends and actively listens and participates in the regularly scheduled Referral Coordinator meeting.
  • Remains current on referral policies and procedures, payer requirements and Managed Care Matrix utilizing the various on-line resources.
  • Processes referrals for services requested by Providers within established guidelines.
  • Obtains authorizations for referrals and schedules appointments as appropriate and within required timeframes.
  • Coordinates appointment date, time and location with patients.
  • Processes requests for additional referrals/authorizations when requested by providers.
  • Assures referrals are maintained within appropriate network or payer requirement.
  • Communicates with all stakeholders, staff, providers, payers and patients as appropriate and per procedure.
  • Documents required information into the appropriate systems.
  • Provides a standard of excellence as it relates to customer service for patients, staff members, and other customers
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