Referral Coordinator II

If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.

Day - 08 Hour (United States of America)
This is a Stanford Medicine Partners job.

A Brief Overview Under general supervision, operates as part of the care team performing a variety of functions such as obtaining referral/authorizations required for future appointments. Patient registration, insurance coverage and eligibility verification, scheduling and telephone management.

Distinguished Characteristics:

RIT PSR II is responsible for supporting all elements of referral and authorization to include validating patient's health plan eligibility and obtaining authorization for all services and procedures in office and external facilities. Contacting patients and scheduling into the Epic system by following SOP's provided by the Clinic.

Contacting clinical staff to coordinate peer to peer calls between Physicians and the health plan as needed.

Locations Stanford Medicine Partners What you will doC-I-CARE (1,
2):

Executes world class practices of service and patient care in support of C-I-CARE standards.

Uses C-I-CARE templates and the following components for all communication with patients and staff:

CONNECT with people by calling them their proper name, or the name they prefer (Mr., Ms., Dr.)INTRODUCE yourself and your role COMMUNICATE what you are going to do, how long it will take, and how it will impact the patient ASK permission before entering a room, examining a patient or undertaking an activity RESPOND to patient’s questions or requests promptly; anticipate patient needsEXIT courteously with an explanation of what will come next Patient Registration (1,2):

Registers new patients and updates existing patient accounts in a courteous and professional manner in accordance with performance standards.

Identifies accepted insurance plans and those requiring referrals.

Handles any system red flags as they are encountered.

Communication and Scheduling Procedures (1,2):

Performs off-site scheduling of new or follow-up appointments in a courteous and professional manner in accordance with performance standards.

Coordinates and Communicates with Clinics Electronic Health Record Documentation (1,2):

Accesses EHR to communicate to clinical staff members and/or physicians through telephone encounters using SBAR format and/or appropriate smart phrases in accordance with performance standards.

Manages EHR in-basket(s), referral work queues in accordance with performance standards.

Referral & Authorization Coordination (1,2):

Ensure patient registration is complete including demographic, insurance card and pharmacy benefits is obtained and scanned into the patient’s chart in EPIC.Confirm eligibility and re-verify when required.

Contact health plan for benefit information.

Review EPIC work queue for all request for office based services and procedures.

Defer for x amount days depending on services.

Work accounts that previously deferred for follow up as needed.

Schedule new consultation once authorization has been received and remind patients of scheduled appointments.

Collaborate with Revenue Cycle on authorization claim denials. Research and provide information to Insurance Follow Up Manager for claim appeals.

All other duties as assigned including department-specific functions and responsibilities (1,
2):

Performs other duties as assigned and participates in organization projects as assigned.

Adheres to safety, P4P’s (if applicable), HIPAA and compliance policies.

Provides orientation and training to new staff as assigned.

Education Qualifications High School Diploma or GED Required Experience Qualifications1+ year to 2 years as a Patient…