Coordinator-Referral & Surgery

Loma Linda University Health; Loma Linda (CA); On-site; USD 40,000 - 60,000; Full time

Job summary

Loma Linda University Health is seeking a Coordinator-Referral & Surgery to manage and coordinate insurance authorizations for services requiring approval. The role ensures referrals are complete and pre-certifications are processed, while supporting front office staff and patients with insurance-related issues.

Responsibilities include maintaining confidentiality, training staff, and providing high-quality service.

Qualifications

• High School Diploma or GED required.
• One year front office experience required.
• Clinical office experience preferred.

Responsibilities

• Manages and coordinates the authorization process for referrals and services requiring authorization.
• Processes pre-certifications for ancillary testing as required.
• Assists in directing front office personnel and monitors productivity.
• Provides assistance to clinical staff with insurance issues and patient referrals.

Skills

Insurance guidelines

ICD/CPT coding

Epic system

EOB interpretation

Typing 40 wpm

Office software

Multitasking under pressure

Attention to detail

Customer service

Education

High School Diploma or GED

Front office experience: 1 year

Tools

Epic system

Job description

Department: UHC: Surgery - Shared 2

Job Summary

Coordinator-Referral & Surgery manages and coordinates the authorization process for patients of all reimbursement types for any services requiring such authorization. Ensures all referrals received from providers are complete with necessary information to facilitate authorization process. Processes pre-certifications for ancillary testing as required. Assists in directing front office personnel, performing various functions, monitoring productivity, emphasizing completeness, accuracy and concern for the patient. Provides assistance and training to clinical office staff with insurance issues and assists patients with referral and insurance related issues. All activities must be conducted in a highly confidential, professional and personable manner. Provides high quality service to all customers. Performs other duties as needed.

Education and Experience

High School Diploma or GED required. One year front office experience required. Clinical office experience preferred.

Knowledge and Skills

Current working knowledge of all insurance types and their guidelines, including the ability to read and interpret EOB's. Working knowledge of current ICD and CPT coding systems required. Knowledge of Epic system preferred. Able to keyboard 40 wpm. Able to use a computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint). Operate/ troubleshoot basic office equipment required for the position. Able to work calmly and respond courteously when under pressure; collaborate and accept direction. Able to think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.

Licensures and Certifications

Valid Driver's License at time of hire.