Referral Coordinator/Full Time/Days

Penn Medicine; McGovernsville (PA); On-site; USD 42,000 - 64,000; Full time

Job summary

Penn Medicine is seeking a qualified professional to plan, organize, direct, and coordinate all aspects of the referral office. The role requires handling referral workflows, insurance deadlines, and accurate documentation while serving as the primary contact for insurance and referrals with patients and providers.

The incumbent will liaise between patients and doctors, ensure proper documentation, and collaborate with LG Patient Financial Services to maintain credentialing and compliance.

Qualifications

• High school diploma or certificate.
• One year of computer experience.
• One year clerical or clinical experience in a medical practice setting.
• One year experience in medical referral insurance.
• One year of using medical terminology.

Responsibilities

• Plans, organizes, directs and coordinates all aspects of the referral office.
• Coordinates and monitors daily work flow processes and activities for meeting required referral insurance deadlines within 72 hours or as directed by provider.
• Serves as the first-line resource for all customers regarding Insurance and Referrals and knowledge of insurance verification and authorization referral processes.

Skills

Computer experience

Clerical experience

Medical terminology

Referral insurance knowledge

Education

High school diploma

Job description

Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Summary

• Position Summary: Plans, organizes, directs and coordinates all aspects of the referral office.
• Qualified individuals must have the ability with or without reasonable accommodation to perform the following duties:
• Coordinates and monitors daily work flow processes and activities for meeting required referral insurance deadlines within 72 hours or as directed by provider - e.g., Stat emergent .
• Daily reviews and monitors referral work que in order to provide accurate and timely referral process documentation.
• Serves as the first-line resource for all customers internal external with regards to Insurance and Referrals. Must be knowledgeable in all areas of insurance verification and authorization referral processes.
• Maintain accurate and current referral log on all patients.
• Serve as liaison for patient with doctor offices with regards to processing referrals. Communication may be via fax telephone electronically.
• Review and analyze managed care patient visits and ensure proper documentation of required services.
• Coordinate internal functions and recordkeeping related to managed care organizations to meet compliance.
• In collaboration with staff in LG Patient Financial Services, ascertain physician credentialing is current and required documentation on file.
• Organizes in-service programs for staff regarding all referral insurance process changes and updates.
• Liaison between patient and insurance company to explain to patient what their insurance company requires to meet referral authorization compliance.
• Must have the ability to communicate in a positive, customer service manner when communicating with all customers or when using Department tools i.e., telephone, fax, email, voice mail, etc. .
• Exhibits teamwork and excellent customer service skills without exception, at all time for both internal and external customers.
• Collaboratively works with internal external LG staff, other physician offices, and outside agencies, to resolve patient questions and complaints regarding referral insurance issues.
• The following duties are considered secondary to the primary duties listed above:
• Maintains knowledge of registration and scheduling processes with the capability of filling in as needed based on office workload or staffing demands.
• As needed, assist Billing Coordinator with assigned tasks.
• Provide educational sessions to resident physicians and staff.
• Identifies any system dysfunction or discrepancies and reports to Supervisor Manager, making recommendations for improving current department and hospital-wide procedures.
• Assist with other projects or responsibilities as required by Supervisor Manager.
• Addresses gaps in care in an attempt to help patients reconcile any remaining health care screenings or surveillances.
• May outreach to patients who expresses a desire for a new LGHP PCP to schedule an appointment. Outreaches to patients who have not been seen within the prior 18 months at their LGHP PCP office and schedules patients accordingly to maintain their LGHP relationship.
• Other duties as assigned.

Responsibilities

Minimum Required Qualifications

• High school diploma or certificate
• One 1 year of computer experience
• One 1 year clerical or clinical experience in a medical practice setting
• One 1 year experience in medical referral insurance
• One 1 year of using medical terminology

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.