Referral Specialist

UCHealth; Fort Collins (CO); Presencial; USD 27.000 - 35.000; Tempo integral

Benefícios oferecidos por esta vaga

Medical, dental and vision coverage

PTO and paid leave

Tuition assistance and education Reimb

Resumo da vaga

UCHealth Family Medical Clinic - Ft Collins, CO is hiring for an onsite, full-time role in the PVH FMC Freestanding department. You will handle eligibility verification, authorizations, referrals, and plan guidelines to ensure compliant patient flow and service excellence.

Requires a High School diploma or GED (associate degree preferred) and at least 6 months in healthcare. Benefits include comprehensive coverage and bonus opportunities, with pay between $19.67 and $25.57 per hour based on

Qualificações

• High School diploma or GED.
• Preferred: Associate's degree.
• 6 months' experience in healthcare.

Responsabilidades

• Verifies eligibility and benefits; obtains authorizations for treatment or precertification of high cost drugs; tracks referrals to ensure compliance with guidelines; tracks formulary requirements.
• Responds to third party payors, employers, internal staff, and physician questions; maintains information on health plan guidelines; provides training on plan requirements; obtains ABN or NEMB if required; ensures provider compliance with plan guidelines.
• Ensures confidentiality of patient and institutional information; provides routine information to customers and relays information appropriately.
• Monitors patient needs and responds to inquiries; prepares written reports.
• Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision; must be able to work in a fast-paced environment and take appropriate action.

Descrição da vaga

Description

Location: UCHealth Family Medical Clinic - Ft Collins, CO

Department: PVH FMC Freestanding

Work Schedule: Full Time, 80.00 hours per pay period (2 weeks)

Shift: Days

Pay: $19.67 - $25.57 / hour. Pay is dependent on applicant's relevant experience

This position is an onsite role and does not offer a hybrid or remote option

Summary

Ensures compliance with managed care, commercial insurance, and public insurance requirements. Submits and tracks referrals. Provides efficient patient flow and service excellence.

Responsibilities

• Verifies eligibility and benefits; obtains authorizations for treatment or precertification of high cost drugs. Tracks referrals to ensure compliance with guidelines. Tracks formulary requirements.
• Responds to third party payors, employers, internal staff, and physician questions. Maintains information on health plan guidelines. Provides training on plan requirements. Obtains Advance Beneficiary Notice (ABN) or Notice of Exclusions from Medicare Benefits (NEMB) if required. Ensures provider compliance with plan guidelines.
• Ensures confidentiality of patient and institutional information. Provides routine information to customers and relays information appropriately.
• Monitors patient needs and responds to inquiries. Prepares written reports.
• Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action.

Requirements

• High School diploma or GED. Preferred: Associate's degree.
• 6 months' experience in healthcare.

Employees are our number one asset.

UCHealth promotes a culture that invests in professional success and personal well-being through a comprehensive total rewards program. *

Recognition

• Performance bonus: UCHealth offers a 3-Year Incentive Bonus to recognize employee contributions to our success in quality, patient experience, organizational growth, financial goals and tenure. The bonus accumulates annually each October and is paid out in October during the third year of employment.
• Performance-based pay increase: The Annual Merit Pay Increase recognizes work performance that meets or consistently exceeds performance standards documented through UCHealth's established evaluation process and accounts for increased experience, skills and cost of living.
• Market reviews: All UCHealth positions are reviewed annually to ensure UCHealth base pay aligns with market standards. Base pay rates are adjusted as needed to stay market competitive.

Health and well-being

• Medical, dental and vision coverage.
• Access to 24/7 mental health and well-being support for employees and dependents.
• Discounted gym memberships and fitness resources.
• Free Care.com membership.
• Voluntary benefits such as accident insurance, critical illness insurance, group legal plan, identity theft protection, pet insurance, auto and home insurance, and employee discount programs.
• Time away from work: Paid time off (PTO), paid family and medical leave (inclusive of Colorado FAMLI), leaves of absence.
• Employer-provided basic life and accidental death and dismemberment coverage with buy-up coverage options.
• Employer-provided short-term disability and long-term disability with a buy-up coverage option.

Retirement and savings

• 403(b) plan with employer matching contribution.
• Additional 457(b) plan may be available.
• Flexible spending accounts for health care and dependent day care; health savings account available when enrolled in high-deductible (HD) medical plan.

Education and career growth

• UCHealth provides access to academic degrees and certificate programs to promote professional and personal growth.
• Up to 100% of tuition, books and fees paid for by UCHealth for specific educational degrees.
• Other programs may qualify for up to $10,000/year pre-paid by UCHealth or up to $5,250/year in the form of tuition reimbursement.
• Access to LinkedIn Learning, which offers thousands of virtual courses and seminars, and internal professional development opportunities.
• Employees have access to free assistance navigating the Public Service Loan Forgiveness program and submitting their federal student loans for forgiveness.

*Eligibility for some programs is based on an employee's scheduled work hours.

We improve lives. In big ways through learning, healing, and discovery. In small, personal ways through human connection. But in all ways, we improve lives.

UCHealth always welcomes talent. This position will be open for a minimum of three days and until a top applicant is identified.

UCHealth recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual's race, color, national origin, language, culture, ethnicity, age, religion, sex, disability, sexual orientation, gender, veteran status, socioeconomic status, or any other characteristic prohibited by federal, state, or local law. UCHealth does not discriminate against any qualified applicant with a disability as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.

Who We Are (uchealth.org)