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Entity: CCA-Penn Primary Care and Penn Specialty Practices
Department: Finance
Location: Penn Medicine Valley Forge- 1001 Chesterbrook Blvd
Hours: FT
Job Summary:
The Botox Referral Coordinator assists the practice manager and providers in maintaining a patient/customer focus, supports the delivery of highest quality care, shares a passion for patient and customer centered care, and assists in meeting or exceeding patient satisfaction and financial and operational targets. The Botox Referral Coordinator is responsible for verifying the patient's insurance and prior authorization, determining if medication is from a specialty pharmacy or considered Buy & Bill, resolving outstanding balances, explaining Allergan copay assistance, processing claims, providing billing statements, and setting up payment plans.
Accountabilities:
• Efficiently and effectively manages Accounts Receivable using established work queues and process flows. Meets established productivity metrics.
• Act as liaison between patient and Allergan to assist with financial assistance, explain Botox Savings Program, assist with application process and provide detailed bills.
• Identifies and tracks third party rejection types to determine rejection patterns. Responsible for facilitating maximized revenue for the practice by managing strategies to collect monies from third party payers and collect past due balances; Processes and checks status of claims
• Coordinates the activities of clinical program(s) and/or initiative(s) within the practice. Assumes a leadership role in program/initiative development, implementation, management, and communication as per direction from practice leadership
• Provides support to practice leadership for establishing, implementing, and maintaining practice policies, procedures and efficient systems that support daily operations and/or clinical program/initiative effectiveness
• Schedules appointments for Botox patients, appropriately informs patient of any appointment time changes, confirms appointments
• Identifies if referral is required for care and verifies validity of location, date & number of visits; Issues referrals for specialists and diagnostic studies as directed; Verifies patient's insurance and prior authorization
• Determines source of patient's medication: specialty pharmacy vs. Buy & Bill; Communicates that patient is cleared for injections
• Maintains up to date knowledge of insurance requirements pertinent to patient service and billing procedures
• Patient Services Associate Duties (as needed/directed) such as answering patient calls, scheduling appointments, responding to caller requests based on principles of practice, triaging calls to appropriate person, and retrieving voicemail messages according to practice protocol
• Establishes positive relationships with patients by demonstrating knowledge of patient history with practice, treating them with compassion and responding to their individual needs
• Performs duties in accordance with Penn Medicine and entity values, policies, and procedures
• Other duties as assigned to support the unit, department, entity, and health system organization
Qualifications:

• Required: H.S. Diploma/GED and 4+ years Experience working within medical office environment.
• Preferred: Bachelors Degree in Business, Accounting, or Healthcare Administration
• 1+ years Experience in physician billing responsibilities or accounts receivable management strongly preferred.
• Coursework in medical terminology preferred. Experience in the insurance/HMO industry or academic medical center strongly preferred.

Licenses, Registrations, Certifications:

• Must pass any required exams for EMR access

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.
Live Your Life's Work
We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.