Description
PRIMARY JOB DUTIES
Gathers, updates and verifies insurance/payer information and ensures accurate entry into the practice management system.
Verifies insurance type and eligibility for care.
Prioritizes referrals based on clinical need as indicated by the ordering provider, and the Medical Services Request Form (MSR).
Completes, and documents, referral / scheduling process for all referrals for initial consult visits, as requested by the ordering provider (includes patient contacts, closure of referral, correspondence notification to PCP, as appropriate).
Observes provider schedules to ensure appointments are booked for correct appointment type and correct time allocation.
Schedules appointments for other specialty referrals and/or other services/procedures. Delivers appropriate information (office visits, labs, radiology reports, etc.) via fax, or in person to the specialty provider.
Schedules appointments and procedures for referrals for numerous Multi-faceted Specialty Care Offices as required.
Obtains additional information from referring provider when requested by consulting provider.
Assists in collection and reporting of statistical data, as requested.
Determines priorities for completion of support functions, tasks and projects.
Provides applicable basic education to patients to optimize the opportunity for customer satisfaction.
Provides assistance to Patient Services Representatives (PSR) and Medical Assistants as needed with referral duties.
Backs up PSR positions as needed.
Consistently demonstrates and promotes a sense of team within the immediate and extended work groups.
Establishes and maintains effective communication with physicians, co-workers and patients.
Participates in peer-based evaluations of other staff in specified areas as needed
Participates in educational programs, staff meetings and in-service meetings.
Performs other job-related duties and responsibilities, as assigned.
Maintains current competency files per Standards and annual requirements.
Hours of Work:
40 hours per week, pre-scheduled between Monday - Friday during established.
Office hours 07:00am-05:30pm and business needs.
Qualifications
REQUIRED:
Minimum of one year's experience in a medical front office setting with experience and knowledge of health insurance/ benefit requirements required.
Knowledge of medical terminology, and insurance rules and regulations required.
Detail oriented with typing and computer input ability and a working knowledge of general office machines required.
Strong organizational and written/spoken communication skills essential. Ability to work independently on a variety of complex tasks, managing competing deadlines.
In depth working knowledge of Windows and Microsoft Word. Knowledge of ICD-9, ICD-10 and CPT-4 coding.
Strong ability to multi-task; schedule appointments for several multi-disciplinary clinics.
PREFERRED:
High school graduate or GED preferred.
One or more year's of experience working with medical insurance plans preferred. One or more years of experience working with referrals/consult processes in the specialty care setting. Examples: Pulmonology, Surgery, Urology, Women's Health, Gastroenterology, Cardiology, Infectious Disease and Endocrinology preferred.
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