Referral Coordinator- Referrals and Authorizations (Full Time/ Day Shift)
M-F between the hours of 730-5
POSITION SUMMARY: Plans, organizes, directs and coordinates all aspects of the referral office.
ESSENTIAL FUNCTIONS: Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties:
- Provides customer service by identifying and addressing customer needs and builds positive interpersonal relationships with customers and team members. Uses sound judgment in handling calls, especially with difficult interactions. Engages personally with the patient and demonstrates strong interpersonal skills via empathy, compassion, and celebration when appropriate.
- Serves as first-line resource for all customers (internal/external) with regards to insurance and referrals. Must be knowledgeable of insurance verification and authorizations/referral processes.
- Processes patient referrals to specialty providers by preparing medical records and providing appropriate clinical information to the specialist.
- Obtain referrals & authorizations for diagnostic testing and procedures; communicates with referring physicians for denials follow up.
- Maintain appropriate and accurate documentation.
- Adheres to team standards and work flows for addressing consults and authorizations.
- Maintains regular consistent attendance, personal appearance, punctuality, and adherence to applicable health and safety procedures.
- Demonstrates excellent “over the phone” patient relations skills, e.g. smiles, cheerfully greets patients, and engages all patients in a genuine, warm, and caring manner.
SECONDARY FUNCTIONS: The following duties are considered secondary to the primary duties listed above:
- Identifies work processes that can be improved upon, eliminated, or handled through electronic processes and escalates to leadership.
- Assist with other projects or responsibilities as required by Supervisor/Manager.
- Update patient insurance in EPIC as needed.
- Basic knowledge of Family Medicine Practices, purpose and operations.
- Basic medical terminology.
- Knowledge of various insurance plans such as Medicaid, Medicare and Commercial insurances.
- Ability to work efficiently and comfortably with all levels of staff.
- Performs other related duties as assigned.
MINIMUM REQUIRED QUALIFICATIONS:
- High school diploma or certificate
- One (1) year of computer experience
- One (1) year clerical or clinical experience in a medical practice setting
- One (1) year experience in a customer service related field
- One (1) year of using medical terminology
- One (1) year experience in medical referral/insurance
Disclaimer: This job 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 a reflection of those principal job elements essential for recruitment and selection, for making fair job evaluations, and for establishing performance standards. The percentages of time spent performing job duties are estimates, and should not be considered absolute. The incumbent shall perform all other functions and/or be cross-trained as shall be determined at the sole discretion of management, who has the right to amend, modify, or terminate this job in part or in whole. Incumbent must be able to perform all job functions safely.
PENN MEDICINE LANCASTER GENERAL HEALTH offers the following benefits to employees:
- 100% Tuition Assistance at The Pennsylvania College of Health Sciences
- Paid Time Off and Paid Holidays
- Shift, Weekend and On-Call Differentials
- Health, Dental and Vision Coverage
- Short-Term and Long-Term Disability
- Retirement Savings Account with Company Matching
- Child Care Subsidies
- Onsite Gym and Fitness Classes
Posted on 09/02/2022
PENN MEDICINE LANCASTER GENERAL HEALTH is an Equal Opportunity Employer, committed to hiring a diverse workforce. All openings will be filled based on qualifications without regard to race, color, sex, sexual orientation, gender identity, national origin, marital status, veteran status, disability, age, religion or any other classification protected by law.
Search Firm Representatives please read carefully: PENN MEDICINE LANCASTER GENERAL HEALTH is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past practice, all resumes submitted by search firms to any employee at PENN MEDICINE LANCASTER GENERAL HEALTH via-email, the Internet or directly to hiring managers at Penn Medicine Lancaster General Health in any form without a valid written search agreement in place for that position will be deemed the sole property of PENN MEDICINE LANCASTER GENERAL HEALTH, and no fee will be paid in the event the candidate is hired by PENN MEDICINE LANCASTER GENERAL HEALTH as a result of the referral or through other means.