Referral Specialist

Banner Health; Fallon (NV); Sur place; USD 42 000 - 65 000; Plein temps

Résumé du poste

Banner Health's Fallon clinic is seeking a Referral Specialist to coordinate referral orders for specialty services and diagnostics within a primary care setting. You will ensure payor authorization, track referrals, and maintain client communication to close care gaps.

You will work with patients, providers, and outside resources, applying medical terminology and HIPAA knowledge while keeping up-to-date with payer requirements in a fast-paced environment.

Qualifications

• High school diploma or GED required.
• 1 year direct patient interaction/healthcare experience preferred.
• Knowledge of HIPAA regulations and strong customer service focus.
• Effective verbal and written communication skills and ability to manage competing priorities.
• Proficiency with commonly used office software.

Responsabilités

• Schedules patient referrals for specialty services and diagnostic testing.
• Acts as liaison between patients, providers and staff for referrals and follow-up.
• Verifies coverage, obtains authorization, and communicates with payors/facilities.
• Tracks referrals at 30/60/90 day intervals and follows up with patients.
• Maintains up-to-date knowledge of insurance regulations and payor sources.
• Collaborates with outside referral sources and community resources.
• Handles communications with patients, physicians, and third-party payers within guidelines.

Connaissances

Customer service

Verbal communication

Written communication

Formation

High school diploma or GED

Outils

Microsoft Office

Description du poste

Primary City/State:

Fallon, Nevada

Department Name:

Fallon PCP RHC

Work Shift:

Day

Job Category:

Administrative Services

Health care is changing, and it’s our goal to create a new model to answer America's health care challenges today and in the future. Our passionate and talented teams will be the change on the health care landscape in our communities – big and small. If taking access and delivery from complex to easy, from costly to affordable and from unpredictable to reliable sounds interesting to you, we want to hear from you.

Bring your desire to learn and grow with us to our ever-growing clinic, where you’ll be working side by side with medical staff to create a great patient experience. As a Referral Specialist on our team, we offer a customer-focused and friendly work environment with career growth opportunities. A career with our team is great if you are just starting out or have many years of experience. Bring your desire to learn and grow with us to our ever-growing Primary Care Clinic, where you’ll be working side by side with medical staff to create a great patient experience. Bring your dedication and determination to succeed. You will have a daily opportunity to learn new things and utilize your decision-making skills to make a difference in the lives in our patients

Location: Banner Churchill Community Hospital- Banner Health Clinic

Schedule: Monday-Friday 7am-3:30pm

At Banner Medical Group, you'll have the opportunity to perform a critical role in the community where you practice. Banner Medical Group provides both primary and specialty care throughout the communities in which Banner Health operates. We do this in a variety of settings - from smaller group practices like our Banner Health Clinics in Colorado and Wyoming, to large multi-specialty Banner Health Centers in the metropolitan Phoenix area. We currently have more than 1,000 physicians and more than 3,500 total employees in our group and are seeking others to enhance our ability to deliver our nonprofit mission of providing excellent patient care.

POSITION SUMMARY

This position is responsible for coordinating referral orders for a continuation of treatment, such as specialty services and diagnostic testing within a primary care practice. This position provides all pertinent clinical information needed for the payor authorization and the facility or specialist prior to the services being rendered. The position is responsible for tracking and managing all referrals with the intention and outcome to close any patient care gaps, along with providing documentation to promote team awareness.

CORE FUNCTIONS

1. Schedules appointments for specialty physician services and diagnostic testing per provider request and communicates with the patient on a timely basis for all scheduling requirements
2. Acts as a liaison between patients, providers and staff members for patients’ referral and follow up needs. Provides prompt and professional service for the patients by assisting in educating patient/family and assisting patients with external resources when needed.
3. Provides all pertinent clinical information needed for the payor authorization, the facility or specialist prior to the services being rendered by verifying coverage, obtaining authorization and communicating with receiving facilities
4. Tracks and manages all referrals by monitoring outstanding referrals at 30/60/90 day intervals and following up with patients if appointments are not kept
5. Applies knowledge of medical terminology and maintains up to date knowledge of insurance environment. Utilizes internal and external resources to seek knowledge about regulations regarding various payor sources
6. Collaborates with outside referral sources and other community resources. Maintains an updated list of community resources and networks with colleagues to develop additional referral sources
7. This position has frequent communications with patients, physicians, staff, and third party payers. The position must work with and understand the concepts of managed health care and be able to prioritize tasks within established guidelines with moderate supervision

MINIMUM QUALIFICATIONS

High school diploma/GED or equivalent working knowledge.

Possesses 1 year of direct patient interaction/experience in a medical, insurance, or healthcare related industry.

Knowledge of HIPAA regulations. Strong customer service focus and willingness to problem solve. Effective verbal and written communication skills and the ability to manage competing priorities. Must be proficient with commonly used office software.

PREFERRED QUALIFICATIONS

Previous knowledge of managed care concepts. Working knowledge of medical terminology and ICD-9 and CPT codes.

Additional related education and/or experience preferred.

EEO Statement

EEO/Disabled/Veterans (https://www.bannerhealth.com/careers/eeo)

Our organization supports a drug-free work environment.

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EOE/Female/Minority/Disability/Veterans

Banner Health supports a drug-free work environment.

Banner Health complies with applicable federal and state laws and does not discriminate based on race, color, national origin, religion, sex, sexual orientation, gender identity or expression, age, or disability