Overview
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.
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.
Qualifications
Experience 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
Preferred Experience:
• Computer experience - preferred
Education:
• High School Diploma or GED equivalent - required • Certificate Medical Terminology - preferred
UFJPI is an Equal Opportunity Employer and Drugfree Workplace