Referral Specialist

GLBHC; Saginaw (MI); On-site; GBP 29,000 - 39,000; Full time

Job summary

GLBHC is seeking a detail-oriented Medical Office Coordinator to support scheduling, referrals, and prior authorizations at our Michigan sites. You will communicate with patients and providers, document activities in the EHR, and ensure smooth transitions of care across referrals and tests.

The role requires at least a high school diploma, 3 years in a medical setting, and strong telephone etiquette along with proficiency in Microsoft Office and office equipment.

Qualifications

• High school diploma required; Medical Assistant training preferred.
• Three years of experience in a medical setting.
• Excellent telephone etiquette and clerical skills.
• Proficiency with Microsoft Office and office equipment.
• Maintains patient confidentiality at all times.

Responsibilities

• Answers incoming departmental calls and routes as needed.
• Processes insurance authorizations for referrals needing prior auth.
• Communicates with patients about appointments and tests.
• Follows tracking guidelines on pending requests and TOC.
• Documents all activity in the EHR and TOC transmissions.

Skills

Telephone etiquette

Clerical skills

Microsoft Office

Communication

Time management

Education

High school diploma

Medical Assistant program preferred

Registered MA or certification preferred

Healthcare-related field education required

Tools

Microsoft Office

Office equipment operation

Job description

Billing 3037 Davenport Saginaw, MI 48602, USA

Description

ESSENTIAL JOB DUTIES

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Answers incoming departmental calls, ensuring that all calls are handled or routed as appropriate. (10%)
• Processes the insurance company authorization per the preferred method (electronic, fax, telephone) for any referral requiring prior authorization. Notifies specialist office or testing facility of prior auth approval/auth number if required. Ensures that all authorizations are communicated to entities applicable in the process, and that relevant documentation is shared according to established practices within GLBHC guidelines. (45%)
• Responsible for communicating with patients regarding scheduled appointments and/or tests. Uses appropriate method of communication based upon timing of appointments, as established in departmental protocol. (15%)
• Responsible for following established tracking guidelines on pended requests for specialist, testing appointments and prior authorization results. (15%)
• Documents all activity related to referral/test order in the EHR; documents the appointment date and time. Completes Transition of Care (TOC) activities, documents the transmission of TOC with every referral completed. (15%)

Note: This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

MARGINAL JOB DUTIES

• Provide reminder calls to patients of up-coming referral appointments.
• Assist with data collection as designated by manager.
• Perform other duties as assigned.
• You are expected to give priority to STAT orders, Urgent orders, daily testing, then normal orders for the assigned sites, in that order, on a daily basis.
• Productivity expectations are:
• After 3 months experience, a minimum weekly output standard is 115 "counted referral output".
• After 6 months experience, an average of 125 weekly output standard, or the equivalent, is expected to be accomplished and maintained for our staff within the department.
• You are expected to actively participate in a teamwork environment to accomplish the departmental goal of "yesterday's referrals today".
• You are expected to exhibit excellent customer service skills, on a daily basis, to all customers; patients, providers, co-workers, outside office staff, "everyone you encounter" in your work here at Great Lakes Bay Health Centers.

REQUIRED JOB SPECIFICATIONS

• Education: High school diploma. Completion of a Medical Assistant program preferred. Registered MA or certification preferred. In lieu of medical training, five years or more experience considered. Education in a healthcare related field required.
• Licensure: N/A
• Experience: Minimum of three (3) years of experience in a medical setting
• Skills: Excellent telephone etiquette. Clerical skills such as filing and completion of forms. Legible handwriting. Ability to operate office equipment including computer, fax machine, copy machine, etc. Able to follow through with assignments. in a timely manner. Must be able to use Microsoft Office and other applications as necessary. Ensures that patient. confidentiality is maintained at all times.
• Interpersonal Skills: Able to communicate effectively with, and relate to, diverse population. Must be able to define problems, collect data, establish facts, draw conclusions to resolve issues/problems that occur during the referral process. Ability to follow oral and/or written instructions. Able to work independently and/or as a team member. Must exhibit excellent customer service skills daily.
• Physical Effort: Must be able to sit, stand, and or walk for an entire workday. Must be able to lift, carry, push, pull, and or twist while holding up to 25 lbs. occasionally.
• Hours of Work: Full-time; Flexible and varied. Some evening or weekend hours may be required.
• Travel: Generally, not a requirement of this position. Occasional travel between sites may be required. Travel for meetings and/or conferences, if scheduled. Reimbursement for usage of personal vehicle as outlined under GLBHC's policy or usage of a company vehicle as appropriate.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex,sexual orientation,gender identity, or national origin.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.