Referral & Authorization Specialist

University of Florida Jacksonville Physicians, Inc.; Jacksonville (FL); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Equal Opportunity Employer

Drug-free Workplace

Job summary

University of Florida Jacksonville Physicians, Inc. seeks a Referral Coordinator to manage referral requests for all providers in the clinic module and secure necessary referral/authorization numbers for services.

You will train in referral processes, participate in coordinator meetings, and stay current on policies, payer requirements, and Managed Care Matrix. Responsibilities include processing referrals, obtaining authorizations, and coordinating appointments with patients.

Qualifications

• 2 years - Customer service - required
• 2 years - Third party payers (insurance carriers) using commonly used concepts, practices and procedures in the field - required
• 2 years - Diagnosis and Procedural coding - preferred
• High School Diploma or GED equivalent - required
• Certificate Medical Terminology - preferred

Responsibilities

• Attends Referral training class and various referral system training classes within 1st month of employment.
• Attends and actively listens and participates in the regularly scheduled Referral Coordinator meeting.
• Remains current on referral policies and procedures, payer requirements and Managed Care Matrix utilizing the various on-line resources.
• Processes referrals for services requested by Providers within established guidelines.
• Obtains authorizations for referrals and schedules appointments as appropriate and within required timeframes. Coordinates appointment date, time and location with patients.
• Processes requests for additional referrals/authorizations when requested by providers.
• Assures referrals are maintained within appropriate network or payer requirement.
• Communicates with all stakeholders, staff, providers, payers and patients as appropriate and per procedure.
• Documents required information into the appropriate systems.
• Provides a standard of excellence as it relates to customer service for patients, staff members, and other customers.

Skills

Customer service

Payer requirements

Communication

Education

High School Diploma or GED

Medical Terminology certificate

Job description

University of Florida Jacksonville Physicians, Inc. seeks a Referral Coordinator to manage referral requests for all providers in the clinic module and secure necessary referral/authorization numbers for services.

You will train in referral processes, participate in coordinator meetings, and stay current on policies, payer requirements, and Managed Care Matrix. Responsibilities include processing referrals, obtaining authorizations, and coordinating appointments with patients.