Primary Responsibilities:
- Manage the internal/ external referral process and daily referral reconciliation gathering required information and documents needed, working them accordingly in compliance with established timelines
- Answers telephone and assists caller through the phone queue with scheduling and other needs based on the call type
- Participate in clinic and market education, training, and meetings as needed and/or required
- Maintains knowledge and ensures procedures are followed including referral guidelines and policies, privacy, and confidentiality
- Deliver quality customer service, managing the referral process professionally and in a timely manner mainting professionalism and a
positive attitude with all internal and external customers/peers - Ability to work independently
- Obtain and update prior authorizations and referral authorizations for both internal and external specialty offices
- Being a patient advocate for quality healthcare in external facilities, maintaining the strictest confidentiality
- Retain and utilize knowledge of insurance policies and procedures
- Performs all other related duties as assigned
- Act as a subject matter expert in role of senior coordinator with the ability to assist others
- Assist physicians and nursing personnel with injections, EKGs, phlebotomy and other patient care procedures
- Maintain established quality control standards
- Record and process patient care documentation quickly and accurately
- Coordinate patient care as directed by physicians, company standards and policies
- Organize, stock and clean exam and treatment rooms and sterilize instruments
- Maintain quality control standards and required Medical Assistant and CPR certifications
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
- High school diploma or GED equivalent
- Current, nationally recognized Medical Assistant certification or registration or the ability to obtain the designation within 180 days of employment
- 2+ years of Referral management experience
- 1+ years of Health Care related experience
- 1+ years of Medical Insurance experience
- Knowledge of medical terminology
- Current CPR and/or BLS certification or the ability to attain the certification within 30 days of employment
- Proven efficient proficiency in Microsoft Office applications including: Excel, Word and Outlook
- This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor’s diagnosis of disease
Preferred Qualifications:
- 1+ years of proven solid customer service skills
- Knowledge/experience of NextGen, Excel, Powerpoint
- ICD-9/10 and CPT coding experience
- Bilingual fluent in English and Spanish
Physical & Mental Requirements:
- Ability to lift up to 25 pounds
- Ability to push or pull heavy objects using up to 25 pounds of force
- Ability to sit for extended periods of time
- Ability to stand for extended periods of time
- Ability to use fine motor skills to operate office equipment and/or machinery
- Ability to properly drive and operate a company vehicle
- Ability to receive and comprehend and carryout instructions verbally and/or in writing
- Ability to use logical reasoning for simple and complex problem solving
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
