Referral Center Representative

Shift: 8am - 5pm

Location: Moline IL

The Referral Center Representative is responsible forcoordinating patient referrals scheduling specialty exams obtaining insurance pre-authorizations and ensuringaccuratedocumentation to ensuretimelyandaccuratehealthcare access. The role acts as a liaison between patients healthcare providers and third-party payers tofacilitate seamless communication and care coordination.

At UnityPoint Health you matter. Were proud to be recognized as a Top 150 Place to Work in Healthcare by Beckers Healthcare several years in a row for our commitment to our team members.

Our competitive Total Rewards program offers benefits options that align with your needs and priorities no matter what life stage youre in. Here are just a few:

• Expect paid time off parental leave 401K matching and an employee recognition program.

• Dental and health insurance paid holidays short and long-term disability and more. We even offer pet insurance for your four-legged family members.

• Early access to earned wages with Daily Pay tuition reimbursement to help further your career and adoption assistance to help you grow your family.

With a collective goal to champion a culture of belonging where everyone feels valued and respected we honor the ways people are unique and embrace what brings us together.

And we believe equipping you with support and development opportunities is a vital part of delivering an exceptional employment experience.

Find a fulfilling career and make a difference with UnityPoint Health.

• Works on patient referrals by coordinating appointment scheduling and ensuring thetimelyandaccurateprocessing of referral requestsinitiatingreferrals within 24 hours on business days and documenting all stages in Electronic Medical Records (EMR) systems.
• Coordinates and schedules specialty exams diagnostic tests and outpatient services as needed ensuring proper authorization and documentation.
• Obtains and documents insurance pre-authorizations and approvals from Third-Party Payers (TPP) for services as.
• Tracks and monitors referrals ensuring proper documentation and follow-ups for injury cases andmaintainsaccuratereferral reports for management. Acts as a liaison between patients providers employers insurance companies attorneys and healthcare facilities to ensure seamless communication care coordination andtimelynotification of appointments and procedure instructions.
• Monitors and distributes incoming faxesvoicemails and messagesforwardingthem toappropriate personnelas.
• Completes necessary forms and requisitions for referrals and diagnostic testing ensuringaccurateCurrent Procedural Terminology (CPT) / International Classification of Diseases 10th Revision (ICD-10) coding for billing and insurance purposes.
• Maintains current knowledge of payer-specific prior authorization requirements attending virtualworkshopsand reviewing updates from insurance providers.
• Registers patients verifies demographic and insurance information andassistsscheduling of office staff tooptimizepatient flow.
• Supports quality improvement initiatives by tracking referral trendsidentifyingdelays and implementing workflow optimizations.
• Ensures adherence to the Health Insurance Portability and Accountability Act (HIPAA) regulationsmaintainingpatient confidentiality while handling sensitive information.

Education:

• High School Diploma or equivalent required.
• Medical Administrative Secretarial coursea healthcare related course or degree preferred.

Experience:

• One (1) to two (2) years of experience in a clinical office setting preferred.
• Previousexperience in a clinical office setting for occupational health primary care orthopedics pain management or neurology preferred.
• Previousexperience with referrals and prior authorizations in a clinic setting preferred.

License(s)/Certification(s):

• Certified Medical Assistant preferred.
• IA/ILChild Abuse Mandatory Reporter Training in state(s) where providing care required within90 daysof hire.
• IA/ILDependent Abuse Mandatory Reporter Training in state(s) where providing care required within90 daysof hire.