Coordinator Referrals - Corpus Christi Admin

CHRISTUS Health; Corpus Christi (TX); On-site; USD 42,000 - 56,000; Full time

Job summary

CHRISTUS Health in Corpus Christi, TX is seeking a Referral Coordinator to manage the full referral process for a 35-physician practice. You will obtain orders from physicians, secure insurance authorizations, and schedule patient appointments with physicians who accept the insurance.

You will correct problematic referrals, ensure CPT/ICD-9 coding accuracy, and stay up to date with insurance plans to enable proper payments.

Qualifications

• Must have clinical background knowledge to support referral communications with insurance companies.
• Knowledge of CPT and ICD-9 coding to process proper referrals.
• Familiarity with various insurance plans and coverage for proper payment.

Responsibilities

• Coordinate the referral process from physician order to authorization and scheduling.
• Research problem referral claims or payment requests and correct them.
• Educate nursing associates and physicians on changes in insurance plans for referrals and authorizations.

Skills

Clinical background knowledge

Education

High School Diploma or equivalent

Job description

Summary:

This position is responsible for coordinating the entire referral process (obtaining order from physician, obtaining insurance authorization from the insurance company/Payor, scheduling the appointment for the patient with a physician who accept the particular insurance, notifying the patient of the appointment, completing renewal authorizations with physicians office and Payor) for a 35 physician practice. Researches problem referral claims or requests for payment and corrects. Ensures physicians coding and Dx are appropriate for proper referral and coverage by insurance company. This position is also responsible for knowing various insurance plans and coverages for the patient to ensure proper payment. Responsible to teach nursing associates and physicians all changes within insurance plans for referral and authorization process. Must be up to date with all CPT and ICD-9 coding to process proper referral. Must have clinical background knowledge to appropriately support referral when communicating with insurance companies.

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.

Requirements:

• High School Diploma or equivalent required.
• 1 – 3 years of experience preferred.

Work Schedule:

8AM - 5PM Monday-Friday

Work Type:

Full Time