Patient Referral Navigator

Jobvite, Inc.; Kirkland (WA); On-site; USD 33,000 - 52,000; Full time

Benefits offered by this job

Medical, vision and dental insurance

On-demand virtual health care

Health Savings Account

Flexible Spending Account

Life and disability insurance

Retirement plans (457(b) and 401(a)

Tuition assistance for undergraduate

Paid Time Off/Vacation

Paid holidays

Free parking

Commuter benefits

Job summary

EvergreenHealth in Kirkland, WA seeks a Patient Service Representative to coordinate referrals from PCPs to specialists, interfacing with health plans and providers. Daily interactions with patients, staff, and insurers are required to ensure accurate referrals and timely processing.

Responsibilities include coding patient referrals with ICD-10 and CPT, disseminating managed care information, and adapting to changing insurance requirements.

Qualifications

• Associate degree or equivalent combination of education and experience.
• 3 years of experience in a healthcare insurance or related medical office setting.
• Working knowledge of ICD-10 and CPT codes.
• Ability to be flexible and relate well with others in a professional and pleasant manner.
• Knowledge of medical records confidentiality.
• Excellent communication skills with a high degree of tact and poise to deal effectively with patients, physicians, and hospital staff members.
• Medical Terminology, medical billing, and computer skills.
• Working knowledge of insurances, Medicare, DSHS, Labor and Industries, and other third-party insurances.

Responsibilities

• Demonstrates mastery of all Patient Service Representative duties.
• Processes patient referrals from PCP to specialist, working directly with health plans, troubleshooting when necessary.
• Serves as a point person coordinating information regarding managed care referrals for patients, providers, case managers and other Utilization Management staff.
• Assigns proper ICD-10 and CPT code(s) to patient referrals.
• Responsible for communication and dissemination of key managed care contractual information and system processes to patients and staff.
• Identifies and communicates changes in insurance requirements, provider changes and guidelines to leaders and team members.
• Performs other duties as assigned

Skills

Communication skills

Interpersonal skills

Confidentiality knowledge

Flexibility

Professionalism

Education

Associate degree or equivalent education and experience

Tools

ICD-10/CPT codes knowledge

Job description

EvergreenHealth in Kirkland, WA seeks a Patient Service Representative to coordinate referrals from PCPs to specialists, interfacing with health plans and providers. Daily interactions with patients, staff, and insurers are required to ensure accurate referrals and timely processing.

Responsibilities include coding patient referrals with ICD-10 and CPT, disseminating managed care information, and adapting to changing insurance requirements.