- PRIMARY FUNCTION
- Obtain authorization from insurance companies to assist patients in the referral system.
- ESSENTIAL FUNCTIONS OF THE JOB
- This list may not include all of the duties that may be assigned.
- Requests for referrals will be initiated by physicians and/or staff and forwarded to the referral coordinator for processing.
- Obtain proper documentation required by insurance companies to have referral authorized; including clinical notes, lab results, consult notes.
- Obtain authorization from the insurance company using insurance websites and written authorization forms as required by insurance companies.
- Data entry of information into computer system.
- Daily contact with insurance companies, specialists, hospitals and parents.
- Update processes as changes are dictated by plans and referral supervisor.
- Cover other offices when coordinator is on vacation.
- PERFORMANCE REQUIREMENTS
- High School diploma or equivalent. Medical Assistant Certificate preferred.
Knowledge, Skills & Abilities:
- Knowledge of medical terminology, grammar, spelling and punctuation to type correspondence. Knowledge of insurance industry. Skills in operating a computer, fax and photocopy machine. Ability to read understand and follow oral and written instruction. Ability to sort and file materials correctly by alphabetic or numeric systems. Ability to speak clearly and concisely. Ability to establish and maintain effective working relationships with patients, employees and the public. Typing ability of 40 w.p.m. , word processing and computer experience.
- One year experience in dealing with referral processing and health insurance companies.
Adhere to all organizational information security policies and protect all sensitive information including but not limited to ePHI and PHI in accordance with organizational policy, Federal, State, and local regulations.