Overview

This position is responsible for processing referral requests for all providers practicing within the clinic module and ensuring that when needed, referral/authorization numbers are obtained for these services.

Responsibilities

• Attends Referral training class and various referral system training classes within 1st month of employment.
• Attends and actively listens and participates in the regularly scheduled Referral Coordinator meeting.
• Remains current on referral policies and procedures, payer requirements and Managed Care Matrix utilizing the various on-line resources.
• Processes referrals for services requested by Providers within established guidelines.
• Obtains authorizations for referrals and schedules appointments as appropriate and within required timeframes.
• Coordinates appointment date, time and location with patients.
• Processes requests for additional referrals/authorizations when requested by providers.
• Assures referrals are maintained within appropriate network or payer requirement.
• Communicates with all stakeholders, staff, providers, payers and patients as appropriate and per procedure.
• Documents required information into the appropriate systems.
• Provides a standard of excellence as it relates to customer service for patients, staff members, and other customers.

Qualifications

Experience Requirements:

• 2 years - Diagnosis and Procedural coding - preferred
• 2 years - Experience in the field or in a related area - required
• 2 years - Customer service - required
• 2 years - Third party payers (insurance carriers) using commonly used concepts, practices and procedures in the field required

Preferred Experience:

• Computer experience - preferred

Education:

• High School Diploma or GED equivalent - required
• Certificate Medical Terminology - preferred

Travel

Up to 10%

UFJPI is an Equal Opportunity Employer and Drugfree Workplace