Shift Hours: 830a - 5p, designated late night from 1030a - 7p,
Weekend Committment: One Saturday a month from 745a - 12p.
H.S. diploma or G.E.D.
3~4 years experience in a managed care organization, hospital or physician's office with 1 year referral experience.
Excellent medical terminology comprehension and its effective usage.
Completion of 1 Medical Terminology class with certificate of completion.
Excellent communications skills.
35 wpm keyboarding preferred.
Experience with IDX, Windows and other I.S. systems.
Good organizing skills.
Good problem~solving skills.
Ability to handle difficult calls and maintain professional conduct.
Excels as a team player.
Flexible with job responsibilities.
Ability to work independently.
Ability to handle stress and high workload volumes.
Ability to communicate denial of services to members and providers.
Purpose: The Referral Coordinator position is responsible for coordinating all referral requests and following up on all necessary documentation, certification and authorization requirements. A key responsibility is use of the automated managed care information system to process referrals. Accountabilities:
Coordination of the Referral Process
Reviews all payor requirements by type of service and organizes materials to ensure appropriate referral and that steps are followed to avoid claims denials.
Participate in education and eligibility problem resolution.
Establish controls and a tickler system set~up to see if services are obtained.
Assures that referral documentation is filed in the medical record and physician sees clinical results of the referrals based on a tracking system put in place.
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