The purpose of this role is to improve patient outcomes and reduce health disparities for AbsoluteCARE patients.
We are looking for an experience Referral Coordinator to join our team!
Essential Duties and Responsibilities:
- Process incoming and outgoing calls to secure referrals and authorizations from providers and insurance companies
- Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety.
- Update patient electronic profiles accordingly and providing excellent customer service
- Ensure complete and accurate registration, including patient demographic and current insurance information
- Perform support for on-line authorization of routine services
- Update insurance information as needed; document in EMR and communicate to Office Manager any new insurance findings
- Assemble information concerning patient’s clinical background and referral needs. Per referral guidelines/protocol, provide appropriate clinical information to specialist.
- Review and update Referral information into EMR.
- Assist in gathering information needed to determine continued authorization
- Contact providers with authorization, denial and appeals process information as necessary
- Confirm billing information is accurate in system
- Contact insurance companies to ensure prior approval requirements are met.
- Present necessary medical information such as history, diagnosis and prognosis. Provide specific medical information to insurance companies to maximize reimbursement to AbsoluteCARE.
- Contact patient and insurance companies to verify eligibility
- Other duties assigned
- 2+ years prior experience in a Medical office environment
- Successful completion of high school or equivalent
- Proficient utilizing Excel and MS Word
- Experience with Referrals and Insurance Authorizations
- Familiarity with Billing and Coding functions
- Must have experience with Medicaid insurances
- Critical decision making and problem solving abilities
- Effective verbal and written communication skills
- Ability to interact in a culturally and linguistically appropriate manner
- Must be detail oriented