What are the responsibilities and job description for the Referral Coordinator - Full-time position at Pioneer Physicians Network?
Job Title: Referral Coordinator- Diagnostic Imaging
Supervisor: Department Manager
Job Description:
In addition to other duties as assigned, this position primarily exists to assist the patients with appropriate referrals, pre-certifications and insurance claim issues. This role emphasizes a team-based approach to care and support each member of the team.
Qualifications:
1. Must have one to two years experience in a health care setting, working in insurance, member relations or nursing.
2. College degree preferred.
3. Must have minimum one year experience working with HMO, commercial, Medicare, and other insurances.
4. Must demonstrate ability to establish and maintain effective working relationships with physicians, patients, and insurance contacts.
5. Must demonstrate strong verbal and written communication skills.
6. Must demonstrate ability to successfully handle stressful situations.
7. Must work flexible hours as needed.
General Duties:
General duties include, but are not limited to, the following abilities:
1. Handle Prior Authorizations & Insurance Coordination
a. Complete prior authorizations for all diagnostic imaging.
b. Communicate with insurance providers to ensure compliance with payer requirements
c. Identify and escalate authorization delays or denials that may impact patient care
d. Follow-up with insurance carriers ensuring that coverage is approved.
2. Complete and forward forms to the physicians for approval, if needed; to assist the patients in securing necessary benefits, etc., with respect to patients’ medical condition.
3. Answer questions from patients and families regarding referrals, benefits, etc., and serve as the contact to resolve patient questions and concerns.
4. Resolve patient issues as they arise related to benefit levels, coverage dates, etc.
5. Act as the resource to physicians, staff and others.
6. Track and analyze data and make recommendations for change.
7. Schedule, track, and follow up on imaging orders to ensure completion.
8. Maintain accurate documentation & compliance
9. Maintain strict confidentiality.
10. Provide in-service education to physicians, staff, etc., related to updates and changes in the referrals process.
11. Perform other related work as necessary to ensure smooth and efficient patient flow and patient satisfaction.
Physical Demands
1. Requires sitting for extended periods of time.
2. Some bending stretching, lifting and stooping may be required.
3. Requires manual dexterity sufficient enough to operate office equipment including but not limited to telephone, keyboard, copier and fax machine.
4. Requires normal range of hearing and vision.
Requires the ability to communicate with patients, office personnel and the community
Job Type: Full-time
Pay: $19.00 - $22.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Experience:
- referral coordinator: 1 year (Preferred)
License/Certification:
- Medical Assistant (Preferred)
Work Location: In person
Salary : $19 - $22