Coordinator Referrals - Other Administration

CHRISTUS Health; Corpus Christi (TX); On-site; USD 40,000 - 48,000; Full time

Job summary

CHRISTUS Health is seeking a Referral Coordinator to manage the end-to-end referral process for a 35-physician practice, including obtaining physician orders, insurance authorizations, and scheduling patient appointments with providers who accept the plan. You will ensure correct CPT/ICD-9 coding and communicate plan changes to clinicians and payors.

Responsibilities include coordinating renewals, addressing claims issues, and educating nursing staff and physicians about evolving insurance

Qualifications

• Clinical background knowledge to support referral communications with physicians and insurance payors.
• CPT and ICD-9 coding knowledge required to process referrals accurately.
• 1–3 years of experience in a related referral/coordinator role preferred.

Responsibilities

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

Skills

Clinical knowledge

Education

High School Diploma or equivalent

Job description

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

Education/Skills

• High School Diploma or equivalent required.

Experience

• 1 – 3 years of experience preferred.

Licenses, Registrations, or Certifications

• None required.

Work Schedule

8AM - 5PM Monday-Friday

Work Type

Full Time