REFERRAL SPECIALIST

St. Mary's Physician Associates; Enid (OK); On-site; USD 32,000 - 52,000; Full time

Benefits offered by this job

Competitive compensation

Generous paid time off

Excellent medical, dental, vision, and

401(k) with company match

Job summary

St. Mary’s Physician Associates in Enid, Oklahoma, is seeking a detail-oriented Scheduling Specialist to manage referrals, pre-authorizations, and scheduling of tests for SMPA providers. The role emphasizes accurate data review and clear communication with clinics and patients.

The ideal candidate will have healthcare experience, strong typing and computer skills, and solid knowledge of insurance processes and HIPAA. Join a multi-specialty team dedicated to accessible patient care.

Qualifications

• High school graduate or GED required.
• Minimum of two years’ experience in a healthcare or clinical setting.
• Knowledge of clinical terminology, insurance billing, procedural and diagnosis coding, and HIPAA privacy standards is strongly preferred.
• Typing, 10 key and computer skills required.
• Proficiency in Microsoft Office applications required.
• Excellent written and oral communication skills required.
• Ability to evaluate clinical data for pre-authorizations and referrals is preferred.

Responsibilities

• Schedule referrals for patients of SMPA providers.
• Pre-authorize and pre-cert tests/procedures for SMPA providers.
• Schedule tests with facilities as directed by SMPA providers/staff.
• Direct communication with SMPA clinics, referred clinics, and patients.
• Review clinical data to report medical necessity to insurance companies.

Skills

Interpersonal skills

Communication

Typing

Microsoft Office

Understanding clinical terminology

Insurance billing knowledge

HIPAA privacy knowledge (preferred)

Time management

Multi-tasking

Education

High school graduate or GED

Tools

Microsoft Office

Job description

Responsibilities

St. Mary’s Physician Associates is a multi-specialty group of employed physicians and midlevel providers that serve a ten-county area in NW Oklahoma. It is located in Enid, Oklahoma which is the county seat for Garfield County. Enid is the seventh largest city in Oklahoma with a population of approximately 65,000 but their primary service area in NW Oklahoma consists of 200,000.

Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve.

Position Summary

Responsible for scheduling referrals for patients of St Mary’s Physician Associates providers, Pre-authorizing & pre-certing tests/procedures for St. Mary’s Physician Associates providers. Scheduling of other tests with facilities at the request of SMPA providers and/or staff. Directly communicates with the SMPA clinics, referred to clinics, and patients. Reviews clinical data to report medical necessity to insurance companies. Performs all work with accord to the mission, vision and values of St. Mary’s Physician Associates, LLC.

Reuirements

Qualifications

• High school graduate or GED required.
• Minimum of two years’ experience in a healthcare or clinical setting.
• Knowledge of clinical terminology, insurance billing, procedural and diagnosis coding, federal and state insurance regulations and HIPAA privacy standards is strongly preferred.
• Typing, 10 key and computer skills required.
• Proficiency in Microsoft Office applications required.
• Required effective interpersonal skills and excellent written, oral communication skills required.
• Acute healthcare knowledge and ability to evaluate clinical data to acquire pre-authorizations and referrals is preferred. Knowledge of third party reimbursement regulations is preferred.
• Patient Management, Billing and Managed Care system processes competency. Understanding of functions and work flow of Clinical/Hospital departments.
• Excellent planning and organizational skills. Demonstration of strong analytical skills and problem-solving abilities. Strong teamwork skills and the ability to effectively communicate with all management levels.
• Results oriented, independently goal directed, able to multi-task and meet established time frames.
• Excellent customer service skills and must be able to work independently.

As a St. Mary's Physicians Associates employee you will be part of a first-class organization offering:

• A Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match
• and much more!

Universal Health Services, Inc.

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune500 corporation, annual revenues were $11.6 billion in 2020. In 2021, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; in 2020, ranked #281 on the Fortune 500; and listed #330 in Forbes ranking of U.S.’ Largest Public Companies. Headquartered in King of Prussia, PA, UHS has 89,000 employees and through its subsidiaries operates 26 acute care hospitals, 334 behavioral health facilities, 39 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 38 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion, and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.