Coordinator,Referrals Job Laguna Hills area,California USA,Healthcare

Schedule - Shift - Hours Full Time - Days

PRIMARY FUNCTION:
Obtain authorization from insurance companies to assist patients in the referral process

SUPERVISION RECEIVED

Reports directly to Referral Manager

SUPERVISORY RESPONSIBILITIES

None

TYPICAL WORKING CONDITIONS

Work may require sitting for long periods of time, manual dexterity sufficient to operate a keyboard, type at 40 wpm, operate a calculator, telephone, copier, and such other office equipment as necessary. It is necessary to view and type on computer screens for long periods and to work in a high‑volume, fast‑paced environment. Ability to work remotely is required.

ESSENTIAL FUNCTIONS OF THE JOB

Obtains authorizations for all referral requests received as assigned

Reviews and understands documentation required by insurance companies to obtain authorization, including clinical notes, lab results, consult notes

Utilizes insurance web portals to obtain authorizations as required

Accurately documents referral details, including status, authorization dates, authorization number, specialist/facility and other relevant information per policy

Effectively communicates updates in referral status with patients, clinicians and office site staff

Interacts professionally with specialists/facilities and insurance plan representatives

Remains current with company, health plan and specialist requirements

Prioritizes use of preferred specialist/facility within the EHR

Meets productivity standards as determined by management team

Manages workloads within notification and request bins in EHR to meet established timeframe expectations

Works collaboratively with department team members to ensure coverage

Manages high priority notifications and requests appropriately

Reviews and updates requests pending authorization daily

Communicates and collaborates effectively with Referral Manager and team members

Education Requirements

High School diploma or equivalent.

License

None

Knowledge, Skills & Abilities

Knowledge of medical terminology, grammar, spelling and punctuation to type correspondence. Knowledge of insurance industry. Skills in operating a computer, fax and photocopy machine. Ability to read understand and follow oral and written instruction. Ability to sort and file materials correctly by alphabetic or numeric systems. Ability to speak clearly and concisely. Ability to establish and maintain effective working relationships with patients, employees and the public.

Typing ability of 40 w.p.m., word processing and computer experience.

Experience

One year experience in a medical office and/or referral coordinator experience preferred.

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to be an accurate reflection of the general nature of level of the job.

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