Referral Coordinator - Remote Texas

Responsibilities

• First point of escalation for all case related issues requiring guidance
• Processes referrals requests and authorizations while working closely with physicians, employers and payors
• Reviews, processes and supports Specialist referral requests by Concentra sites as defined by the market
• Obtains authorization for Specialist referrals and schedules appointments accordingly
• Schedules appointments accordingly
• Schedules appointments accordingly
• Ensures that appropriate networks and Concentra Advanced Specialists are used when applicable
• Provides all necessary information such as medical records, prescriptions, etc. to payor
• Communicates with stakeholders, payor, employer, and patient as appropriate
• Records all appropriate information via OA/CR module of OccuSource per Concentra policy
• Builds relationships with provider, employer and payor communities
• Identifies trends or patterns in missed capture and opportunities to gain capture; communicates these ideas and trends to Lead and Supervisor
• Handles calls according to the call guidelines of the department
• Participates in quality assurance processes including but not limited to the audit program, case reviews and training sessions

Qualifications

• High school diploma or GED equivalent
• Associated Degree from an accredited college preferred
• Customarily at least one year of demonstrated experience in medical environment - service delivery (referrals, claims, insurance, billing, etc.)
• Experience with Worker's Compensation preferred
• Proficiency with scheduling/insurance verification software