Processes physician and outpatient referrals.
Responsible for patient scheduling, obtaining insurance authorization, providing appropriate guidance regarding coverage and closing the loop within the EHR and interfacing with other payer portals for processing referrals.
Enters accurate patient data into EHR, validates information, obtains necessary verifications and pre-authorizations on all new patient appointments.
Faxes related and relevant clinical information to referral source as requested to schedule the appointment.
Prioritizes the urgency of patient referrals; including stats, urgent or routine.
When appropriate initiates a telephone call to the patient as a reminder of their appointment, document information record all attempts to reach patient per protocol.
Communicate and arrange as appropriate any peer to peer communications that need to take place between the provider and the insurance company.
Accurately enters and monitors all referral orders and closes out the referral when completed.
Monitors all needed reports to ensure completion of the referral process.
Other job duties as assigned.
Maintains compliance with all operational policies and procedures.
Must have a high-school diploma, prefer an Associates degree or equivalent degree from a two-year college or technical school, or six months to one-year related experience and/or training; or equivalent combination of education and experience. Prior experience with processing referrals is required. Must be familiar with medical terminology and coverage issues at a payer level. Must have excellent communication skills in person and within the record. Prior EHR experience a plus. Must have excellent computer skills. Must exhibit not only excellent internal but external customer service skills at all times. Must comply with all company procedures and policies.Apply Now!