What are the responsibilities and job description for the Specialty Practice Referral Coordinator - Heart and Vascular (Days) position at Tanner Health?
The Specialty Practice Referral Coordinator works with the Greenway Referral Module this position schedules testing, procedures and referrals for TMG practices. The Coordinator obtains pre-certification prior authorizations for procedures, outpatient tests, and referrals. Position works closely with the practices and maintains strict confidentialty.
Education
Technical or Vocational school plus up to 2 years specialty training
Experience
Two years of related experience. Requires working knowledge of specialized practices, equipment, and procedures.
Qualifications
*2 years of related experience in a clinical environment. Licensed Practical Nurse preferred. Medical Assistant may be considered with equivalent experience.
*Ability to organize, analyze and prioritize work
*Data entry experience preferredBusiness like appearanceDetail orientedAbility to multi-taskAbility to work closely with others and function as a team member
*Exhibit exceptional communication skills
*Must possess the initiative and drive to take a project from beginning to a successful completion
*Working knowledge of CPT and ICD-9 coding required
Education
Technical or Vocational school plus up to 2 years specialty training
Experience
Two years of related experience. Requires working knowledge of specialized practices, equipment, and procedures.
Qualifications
*2 years of related experience in a clinical environment. Licensed Practical Nurse preferred. Medical Assistant may be considered with equivalent experience.
*Ability to organize, analyze and prioritize work
*Data entry experience preferredBusiness like appearanceDetail orientedAbility to multi-taskAbility to work closely with others and function as a team member
*Exhibit exceptional communication skills
*Must possess the initiative and drive to take a project from beginning to a successful completion
*Working knowledge of CPT and ICD-9 coding required
*Will accept 4 years of directly related experience in lieu of education.
Qualifications:
Area of Responsibilities
*Customer Service: Provides customer service functions to include addressing patient, hospital and provider inquiries and complaints from all sources in a timely manner. Initiates necessary corrections to patient accounts and attempts to repair damage done to relationship with patient. This will require interaction with co-workers, physician offices, hospital, insurance carriers, and Administration. Success indicated by problems being resolved by team member requiring little director intervention. Participates in patient satisfaction initiatives. Demonstrates excellent customer service skills Communicates effectively with patients and management regarding service recovery opportunities. Works together with other team members to achieve Office and System customer service goals
*Ensures informed consents are signed prior to procedure and confirms procedure schedule with physician, surgery department, and other departments as needed. Confirms that paperwork is completed to ensure no delays in care or payment for services.
*Informs patients about procedure prep and clearance. Ensures informed consents are signed with 30 days of procedure. Confirms procedure schedule with physician(s), surgical department and other departments as necessary. Performs post-procedure call backs per physician instructions.
*Referral Coordinator duties: Working with the Greenway Referral Module this position schedules testing, procedures and referrals for TMG practices. Obtains pre-certification prior authorizations for procedures, outpatient tests, and referrals. Position works closely with the practices and maintains strict confidentiality.
*Verifies insurance coverage and obtains prior authorization as needed. Communicates financial responsibility to the patient for referral, procedures, or consultation. Attempts to collect monies due to the Medical Group before procedures are scheduled.
*Assists with special projects as needed.
*Development: Maintains a current knowledge of clinical operations including medical knowledge. This will be required to understand referrals requested by providers. Develops and maintains a working knowledge of CPT and ICD coding. Participates in continuing education Participates in the development of new programs.
*Ensure that providers are notified using the Greenway EMR when a procedure, consultation, or result is complete and documentation is available for review by sending notification to the provider.
*Other duties as assigned.
*Prepares productivity reports each month, including but not limited to calls, referrals, and amounts collected. Referral reporting is generated monthly and provided to Administration.
*Teamwork: Works well with others and functions as a team player. Offers ideas and solutions for issues that affect the team and work area. Stocking and ordering of supplies as needed Maintains patient care areas. Participates in the training and skills development of new front office employees. Assists in other areas of the office as necessary
Compliance Statement
Employee performs within the prescribed limits of Tanner Health System's Ethics and Compliance program. Is responsible to detect, observe, and report compliance variances to their immediate supervisor, the Compliance Officer, or the Hotline.
Education
Technical or Vocational school plus up to 2 years specialty training
Experience
Two years of related experience. Requires working knowledge of specialized practices, equipment, and procedures.
Qualifications
*2 years of related experience in a clinical environment. Licensed Practical Nurse preferred. Medical Assistant may be considered with equivalent experience.
*Ability to organize, analyze and prioritize work
*Data entry experience preferredBusiness like appearanceDetail orientedAbility to multi-taskAbility to work closely with others and function as a team member
*Exhibit exceptional communication skills
*Must possess the initiative and drive to take a project from beginning to a successful completion
*Working knowledge of CPT and ICD-9 coding required
Definitions
*The Specialty Practice Referral Coordinator works with the Greenway Referral Module this position schedules testing, procedures and referrals for TMG practices. The Coordinator obtains pre-certification prior authorizations for procedures, outpatient tests, and referrals. Position works closely with the practices and maintains strict confidentialty.
Contact With Others
Requires frequent contact with many persons at different levels inside and outside of the organization to carry out organization policies and programs and obtain willing acceptance, consent, or action.
Effect Of Error
Probable errors not easily detected and may adversely affect external as well as internal relationships and may result in major expenditures for equipment, materials, or procedures detrimental to the patient?s welfare or the organization?s interest. Work is subject to general review only and requires considerable accuracy and responsibility. Continually works with reports, records, plans, and programs of a major functional area of the organization where integrity is required to safeguard the organization?s position. Duties may involve the preparation of data on which the administration bases important decisions and are highly confidential.
Supervisory Responsibility
Regularly uses assistance of aide or helper or leads the work of one to four co-employees; checks performance of work assigned as to accuracy and time, doing same work, it?s more difficult aspects, or other related work
Mental Demands
Work involves a variety of complex problems to be solved under general organization policies. Ingenuity and judgment are required to review facts, plan work, estimate costs, and deal with factors not easily evaluated, interpret results, draw conclusions, and take or recommend action. Solutions to problems often require coordination with other departments.
Physical Effort
Light physical effort - Much of work done while sitting but with more than normal standing or walking. Handles light materials intermittently. Office or laboratory work requiring more than normal visual effort.
Working Conditions
Generally pleasant working conditions/normal office environment.
Physical Aspects
Frequently (at least 3 times a week)
*Typing
*Hearing
*Visual
*Speaking
Occasionally (at least once a month)
*Bending
*Manual Dexterity ? picking, pinching With fingers etc.
*Reaching ? above shoulder
*Reaching ? below shoulder
*Standing
*Walking
*Lifting up To 25 lbs.
*Handling ? seizing, holding, grasping
*Carrying
*Pushing/Pulling ? up To 25 lbs.
*Customer Service: Provides customer service functions to include addressing patient, hospital and provider inquiries and complaints from all sources in a timely manner. Initiates necessary corrections to patient accounts and attempts to repair damage done to relationship with patient. This will require interaction with co-workers, physician offices, hospital, insurance carriers, and Administration. Success indicated by problems being resolved by team member requiring little director intervention. Participates in patient satisfaction initiatives. Demonstrates excellent customer service skills Communicates effectively with patients and management regarding service recovery opportunities. Works together with other team members to achieve Office and System customer service goals
*Ensures informed consents are signed prior to procedure and confirms procedure schedule with physician, surgery department, and other departments as needed. Confirms that paperwork is completed to ensure no delays in care or payment for services.
*Informs patients about procedure prep and clearance. Ensures informed consents are signed with 30 days of procedure. Confirms procedure schedule with physician(s), surgical department and other departments as necessary. Performs post-procedure call backs per physician instructions.
*Referral Coordinator duties: Working with the Greenway Referral Module this position schedules testing, procedures and referrals for TMG practices. Obtains pre-certification prior authorizations for procedures, outpatient tests, and referrals. Position works closely with the practices and maintains strict confidentiality.
*Verifies insurance coverage and obtains prior authorization as needed. Communicates financial responsibility to the patient for referral, procedures, or consultation. Attempts to collect monies due to the Medical Group before procedures are scheduled.
*Assists with special projects as needed.
*Development: Maintains a current knowledge of clinical operations including medical knowledge. This will be required to understand referrals requested by providers. Develops and maintains a working knowledge of CPT and ICD coding. Participates in continuing education Participates in the development of new programs.
*Ensure that providers are notified using the Greenway EMR when a procedure, consultation, or result is complete and documentation is available for review by sending notification to the provider.
*Other duties as assigned.
*Prepares productivity reports each month, including but not limited to calls, referrals, and amounts collected. Referral reporting is generated monthly and provided to Administration.
*Teamwork: Works well with others and functions as a team player. Offers ideas and solutions for issues that affect the team and work area. Stocking and ordering of supplies as needed Maintains patient care areas. Participates in the training and skills development of new front office employees. Assists in other areas of the office as necessary
Compliance Statement
Employee performs within the prescribed limits of Tanner Health System's Ethics and Compliance program. Is responsible to detect, observe, and report compliance variances to their immediate supervisor, the Compliance Officer, or the Hotline.
Education
Technical or Vocational school plus up to 2 years specialty training
Experience
Two years of related experience. Requires working knowledge of specialized practices, equipment, and procedures.
Qualifications
*2 years of related experience in a clinical environment. Licensed Practical Nurse preferred. Medical Assistant may be considered with equivalent experience.
*Ability to organize, analyze and prioritize work
*Data entry experience preferredBusiness like appearanceDetail orientedAbility to multi-taskAbility to work closely with others and function as a team member
*Exhibit exceptional communication skills
*Must possess the initiative and drive to take a project from beginning to a successful completion
*Working knowledge of CPT and ICD-9 coding required
Definitions
*The Specialty Practice Referral Coordinator works with the Greenway Referral Module this position schedules testing, procedures and referrals for TMG practices. The Coordinator obtains pre-certification prior authorizations for procedures, outpatient tests, and referrals. Position works closely with the practices and maintains strict confidentialty.
Contact With Others
Requires frequent contact with many persons at different levels inside and outside of the organization to carry out organization policies and programs and obtain willing acceptance, consent, or action.
Effect Of Error
Probable errors not easily detected and may adversely affect external as well as internal relationships and may result in major expenditures for equipment, materials, or procedures detrimental to the patient?s welfare or the organization?s interest. Work is subject to general review only and requires considerable accuracy and responsibility. Continually works with reports, records, plans, and programs of a major functional area of the organization where integrity is required to safeguard the organization?s position. Duties may involve the preparation of data on which the administration bases important decisions and are highly confidential.
Supervisory Responsibility
Regularly uses assistance of aide or helper or leads the work of one to four co-employees; checks performance of work assigned as to accuracy and time, doing same work, it?s more difficult aspects, or other related work
Mental Demands
Work involves a variety of complex problems to be solved under general organization policies. Ingenuity and judgment are required to review facts, plan work, estimate costs, and deal with factors not easily evaluated, interpret results, draw conclusions, and take or recommend action. Solutions to problems often require coordination with other departments.
Physical Effort
Light physical effort - Much of work done while sitting but with more than normal standing or walking. Handles light materials intermittently. Office or laboratory work requiring more than normal visual effort.
Working Conditions
Generally pleasant working conditions/normal office environment.
Physical Aspects
Frequently (at least 3 times a week)
*Typing
*Hearing
*Visual
*Speaking
Occasionally (at least once a month)
*Bending
*Manual Dexterity ? picking, pinching With fingers etc.
*Reaching ? above shoulder
*Reaching ? below shoulder
*Standing
*Walking
*Lifting up To 25 lbs.
*Handling ? seizing, holding, grasping
*Carrying
*Pushing/Pulling ? up To 25 lbs.