Call Center and Physician Referral Specialist *Repost*

About the role

Coordinates patient care by answering incoming phone calls, scheduling, modifying and confirming patient appointments, processing incoming patient referrals, insurance verification, prior authorization responsibilities, maintaining accurate patient records, and ensuring timely communication with all parties to ensure smooth care coordination.

Responsibilities

• Answer incoming phone calls
• Schedule, modify, and confirm patient appointments
• Process incoming patient referrals
• Perform insurance verification
• Handle prior authorization
• Maintain accurate patient records
• Ensure timely communication with all parties to ensure smooth care coordination

Requirements

• Education/Experience equivalent to graduation from high school and three (3) years of experience in the health care field as a medical office assistant or medical office
• Minimum one (1) year of experience with General Surgery scheduling and referrals
• Minimum one (1) year of experience with Orthopedics scheduling and referrals
• Epic Experience
• Microsoft Excel Experience
• Customer Service Experience
• Bilingual preferred; Spanish is a plus

Qualifications

• Scheduling and authorization procedures
• Medical terminology
• Physician medical specialties
• Community medical/health care services
• Laws, rules, and regulations governing area of assignment
• Financial system and insurance requirements
• Commercial and governmental payers, Medicare plans
• Health insurance, including HMO and PPO plans
• CPT coding, and Medicaid, Medicare, and other third-party insurance carriers billing
• Medicare rules and regulations
• Department and hospital safety practice and procedures
• Patient rights
• Age specific patient care practices
• Infection control policies and practices
• Handling, storage, use and disposal of hazardous materials
• Department and hospital emergency response policies and procedures

Skills

• Communicating effectively with physicians, patients, and other employees
• Customer services
• Computerized scheduling system
• Verbal and written communication, attention to detail, and multitask
• Verifying benefits and eligibility
• Forms and applications according to laws and guidelines in area of assignment