Referral Representative - Pediatric Contact Center

Job Summary

Obtain referrals, pre-certifications and prior-authorizations via internet, faxing forms, and/or making calls to insurance companies. Schedule all procedures and the necessary pre-certification. Schedule all diagnostic tests and all necessary pre-certification. Follow up on all scheduled referral appointments, diagnostic testing, and procedures; confirming scheduled date/time, and patient notification. Document all referrals, procedures, and diagnostic tests in the appropriate log books and retain the information for review. Obtain Prior Authorizations for medications not included on patient formularies. Verify patient insurance 24 hours prior to scheduled appointment time and troubleshoot / eliminate any patient eligibility issues identified. Act as back-up for the PSR position(s). Perform general office duties such as data entry, filing, etc. May be responsible for Invision/Flowcast registration and other functions as designated.

Responsibilities

• Follow up on all scheduled referral appointments, diagnostic testing, and procedures; confirming scheduled date/time, and patient notification.
• Document all referrals, procedures, and diagnostic tests in the appropriate log books and retain the information for review.
• Obtain Prior Authorizations for medications not included on patient formularies.
• Verify patient insurance 24 hours prior to scheduled appointment time and troubleshoot / eliminate any patient eligibility issues identified.
• Act as back-up for the PSR position(s).
• Perform general office duties such as data entry, filing, etc.
• May be responsible for Invision/Flowcast registration and other functions as designated.

Requirements

• High school diploma and training for computer competency.
• Excellent communication skills and ability to interface appropriately with others of multiple ethnic and educational backgrounds.
• Strong organizational skills and a commitment to teamwork.
• Previous experience with appointment scheduling, referrals, patient registration and data entry.
• Prior Centricity/ Flowcast/Invision/SMS experience desirable.

Qualifications

• Clerical experience and/or hospital experience a requirement.
• Always poised, courteous, pleasing personality and great telephone etiquette.

Skills

• Knowledge of general business principles in a related healthcare or business field.

Benefits

• Team-based approach to care.
• Trained to meet the highest level of function for their role as per the State of Tennessee/Georgia guidelines.
• Trained and assigned to coordinate care for patients and support patients/families/caregivers in self-management, self-efficacy and behavior change.
• Trained and assigned to manage the practices' patient population.
• Participates in the practice's quality improvement process and performance evaluation.

Pay

N/A

Schedule

N/A

Department Position Summary

Interaction with third party payers and other departments; and communicating with people of a broad socio-economic mix. Strong organizational skills and a commitment to teamwork are essential. Will work closely in a clinical setting involving some stressful situations, personal flexibility; moderate sitting, standing, stooping, bending and moderate work at portable computers required. Will work closely with other physician offices to keep abreast of any new updates or changes with regards to scheduling, registration and referrals.

Position Requirement(s)

• No license/certification/registration required.

Education Required

High school diploma and training for computer competency.

Preferred

• Medical terminology course desired.

Experience Required

• Must be proven to possess excellent communication skills and be able to interface appropriately with others of multiple ethnic and educational backgrounds.
• Highly organized, detail-oriented, self-starter with strong math skills who can function efficiently and professionally with all customers, both internal and external, in a demanding environment.
• Clerical experience and/or hospital experience a requirement.
• Always poised, courteous, pleasing personality and great telephone etiquette.

Department

Physician Practices Chattanooga, TN

Contact Center Standard Hours

Regular