Referral Coordinator Wound Center

Its more than a career its a calling.

Worker Type:

Job Highlights:

This is a full-time day-shift position working Mon-Fri from 7am-3:30pm.

EPIC experience and experience with referrals and authorizations is highly preferred. Must also have good customer service skills.

Job Summary:

Job Responsibilities and Requirements:

PRIMARY RESPONSIBILITIES

• Attends in-services provided by various health plans.
• Travels to off-site locations as necessary.
• Gathers necessary clinical information and processes referrals pre-certification pre-determinations and pre-authorizes according to insurance plan requirements.
• Logs tracks and reviews managed care approvals and denials.
• Responds in a timely manner to last minute/emergency referrals or additional codes performed during a procedure or procedural changes for pre-authorizations.
• Verifies insurance coverage benefits and creatrs price estimates reverifications as needed (ex; first of the month reverifications for managed Medicaids).
• Works collaboratively with insurance companies providers and staff to ensure plan requirements have been met prior to patient services being rendered in order to maximize reimbursement.
• Preregisters patients for appointments.
• Schedules patients for appointments appropriately.
• Performs all other duties as assigned.

EDUCATION

• High School diploma/GED or 10 years of work experience

EXPERIENCE

• One year experience required

PHYSICAL REQUIREMENTS

• Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
• Frequent sitting standing walking reaching and repetitive foot/leg and hand/arm movements.
• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
• Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms malfunctioning machinery etc.
• Frequent keyboard use/data entry.
• Occasional bending stooping kneeling squatting twisting and gripping.
• Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
• Rare climbing.

REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS

• None

Department:

Work Shift:

Scheduled Weekly Hours:

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