Essential Job Functions, Duties, and Responsibilities
- Ensure complete and accurate registration, including patient demographics and current insurance eligibility and benefits.
- Contact review organizations and insurance companies to ensure prior approval requirements are met.
- Ensure that all referrals and prior authorizations are addressed in a timely manner.
- Identifies, assembles and provides pertinent and current information concerning patient’s clinical condition as well as PMH and diagnosis to refer to specialist/facility.
- Maintains completed documentation in regard to referral/authorization to promote team awareness and status of the referral/authorization at all times.
- Acts as a liaison between hospitals, physicians, health plans, vendors, and patients, or other referral sources. Schedules peer to peer review when necessary.
- Contacts and reviews the details and limitations of the referral with the patient once finalized.
- Other duties as assigned.
The omission of certain position duties does not limit the assignment of additional responsibilities as assigned.
Experience: Recent experience working in a physician office. Demonstrated knowledge of medical terminology and familiarity with third party payer guidelines and requirements.
- Medical terminology knowledge
- Familiarity with third-party payer guidelines and requirements
- Strong customer service focus
- Effective verbal and written communication skills
- Team oriented
- Organized and able to prioritize responsibilities
- Good judgment and problem-solving skills
- Ability to follow through with delegated tasks and accountability
Education: High school graduate or equivalent.
Physical Requirements: The typical demands to successfully perform essential functions of the position:
- Normal vision, hearing, and ability to effectively communicate orally and in writing.
- Ability to lift/carry 1 – 10 lbs.
- Sitting for long periods of time 2 – 4 hours
- Standing / Walking short periods of time 10 – 15 minutes
Reasonable accommodations may be available for individuals with disabilities upon employee written request.
Job Type: Full-time
- relevant: 1 year (Preferred)
- Referral Coordinator: 1 year (Preferred)