Referral Coordinator

Key Responsibilities

• Receive, track and obtain insurance authorization from in-network and out-of-network insurance carriers for referred patient and Follow-Up visits with Specialty care providers.
• Process physician referral orders (EMG, CT, MRI, etc.) using Allscripts (EMR system).
• This includes obtaining any insurance authorization needed.
• Cook up new therapy referrals for insurance plans that require authorization (AHCCCS, work comp, etc).
• This includes obtaining any insurance authorization needed.
• Accurately enter notes into Allscripts (EMR system) regarding letters or correspondence from insurance companies regarding insurance authorization or other notifications.
• These documents should also be scanned into the appropriate patients chart in Allscripts (EMR system).
• Remain updated with therapy & radiology location insurance contracts.
• Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
• Documents all interactions on an account with a Note.
• Ability to write simple correspondence.
• Ability to effectively present information in one-on-one and small group situations to patients, clients, and other employees of the organization.
• Ability to apply common sense understanding to carry out detailed written or oral instructions.

Qualifications

• High School Diploma or GED certificate required; two years related experience and/or training; equivalent combination of education and experience.
• Basic skills using MS Excel and MS Word.
• Ability to handle a high volume of patient flow with comfort and confidence.
• Knowledge of ICD-9 and CPT codes for the purpose of authorizations.
• Knowledge of insurance plans and their rules.