Essential Responsibilities:
1. Receives referrals processed by the referral coordinator.
2. Prioritizes referrals by their urgency and ensures patients are seen in timely manner.
3. Ensures complete demographic, insurance information and appropriate/pertaining clinical information is received before scheduling.
5. Contacts insurance companies to verify, benefits, in network status, prior authorization and/or PCP referral are required. Presents necessary medical information such as, history, diagnosis and prognosis to insurance companies and PCP’s as deemed necessary per insurance, as needed if Referral Coordinator out or busy.
6. Follow up on pending Auths and PCP’s referrals to ensure approval is received before scheduling patient, as needed
7. Reviews details and expectations about a referral with team members as needed
8. Point of contact for patients and providers for any questions or rising concerns. Assist in problem solving potential issues related to their referral if unable to help, assist in finding the right point of contact to further help.
9. Call and complete scheduling process for mobile clinincs and in office patients.
Job Requirements:
- High School/G.E.D requirement or equivalent combination of education and experience required
- 1-2 years prior medical office, preferred not required
- Experience with insurance systems, Medicare and Medicaid online systems preferred
- Ability to understand eligibility benefits, authorizations and PCP referrals.
- Ability to read an Explanation of Benefits
- Knowledge of medical terminology
- Great communication and interpersonal skills
- Proficiency in basic use of computer, telephone, internet, copier, fax, and scanner
- Touch-typing skills, 40 wpm required
- Basic touch 10 key skills
- Basic knowledge of Outlook, Word and Excel
To perform the job successfully, the following competencies should be demonstrated.
Attendance/Punctuality - Is consistently at work and on time, per hours scheduled; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time.
Culture - Treats people with respect; inspires the trust of others; works with integrity and
principles; upholds organizational values; follows policies and procedures; supports organization's goals
and values; shows respect and sensitivity for cultural differences; follows instructions; responds to
management direction; takes responsibility for own actions; keeps commitments; commits to long hours
of work when necessary to reach goals; completes tasks on time or notifies appropriate person with an
alternate plan; asks for and offers help when needed.
Communications - Speaks clearly and persuasively in positive or negative situations; listens and gets
clarification; responds well to questions; demonstrates group presentation skills; participates in
meetings; writes clearly and informatively; edits work for spelling and grammar; keeps others adequately informed; selects and uses appropriate communication methods.
Customer Service for Internal and External Customers/Patients - Manages difficult or emotional
customer/patient situations; responds promptly to customer/patient needs; solicits customer/patient
feedback to improve service; responds to requests for service and assistance; meets commitments.
Hours: Monday – Friday 8:00 am – 5:00 pm
Benefits: Paid PTO, Waiting period may apply
Job Type: Full-Time (required)