Referral Coordinator - Orthopedics

Description Job Description PeaceHealth Ketchikan and/or Prince of Wales is seeking a Referral Coordinator - Orthopedics for a Full Time, 1.00 FTE, Day position. The salary range for this job opening at PeaceHealth is $27.16 – $36.66. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc. Job Summary Assure that the services that are approved by private payors have been done and that we request more visits for patients as we continue through the episode of care. May also be responsible for management of referrals; working closely with team members to ensure optimum utilization and cost containment. Provides clerical support and assistance to staff. Details of the Position Oversees the data entry and completion of referral forms/notifications. Obtains insurance pre-authorization for patients and reauthorization of additional treatment. Ensures insurance carrier (including Medicare) documentation requirements are me and referral support documentation is filed in patient’s medical record.Efficiently manages correspondence with patients, physicians, specialists, insurance companies. Documents pertinent information on referral form and/or in medical record. Ensures practitioners are following standardized guidelines as recommended by evidenced based medicine.Communicates with billing staff and third-party payors to assure coverage of patient care.Performs other duties as assigned. What You Bring Accredited School Preferred: Business or two years college Preferred: Medical Assistant, Licensed Practical nurse, or Registered NurseMinimum of 3 years Required: Experience working in insurance in a medical related field, or other related experiencePreferred: National Certified Medical Assistant orPreferred: Licensed Practical Nurse - Oregon orPreferred: Licensed Practical Nurse - Alaska orPreferred: Licensed Practical Nurse - Washington orPreferred: Registered Nurse Skills Demonstrated experience in insurance requirements for referrals and /or prior authorizations to various therapies (PT, RT, OT, ST), surgeries, procedures, diagnostic testing, and infusions. GYN procedures, testing, etc (Required) Proficient with MS Office applications (Required) Proficient with Horizon Home Care (Required) Department / Location Specific Notes Ketchikan Medical Center: Experience/Training: Minimum of two years’ experience working in insurance in a medical related field or other related field.Will provide administrative support to RN and Pharmacist in case management.Will perform duties of Patient Access Representative Working Conditions Lifting Consistently operates computer and other office equipment.Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.Sedentary work. Environmental Conditions Predominantly operates in an office environment. Mental/Visual Ability to communicate and exchange accurate information.The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading. For additional information or questions, please email Jen Worthington at or call 360-448-0542. PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program. See how PeaceHealth is committed to For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.