Referral Specialist

Tulalip Tribes; Tulalip Bay (WA); On-site; USD 42,000 - 48,000; Full time

Job summary

The Tulalip Tribes is hiring a Referral Specialist to manage referrals in the EPIC queue, coordinate patient appointments, and ensure proper documentation for coverage and prior authorizations.

You will follow up with patients and outside vendors to close referrals once the primary care provider and Tulalip Health Clinic have reviewed the referral.

Qualifications

• High School Diploma or GED required.
• 1 year of CPT and ICD-9 coding experience.
• 1 year of experience with medical terminology.
• 1 year of experience working in the medical field.
• 6 months of Electronic Health Record and/or EPIC experience.
• 6 months of experience with insurance pre-authorization.
• Experience with CHS priority guidelines preferred.
• Experience working with diverse cultures, specifically Native Americans.
• Experience using a scheduling GUI to assist workflow preferred.
• Experience using RPMS preferred.

Responsibilities

• Work daily in the EPIC queue for patient referrals to outside services and coordinate/notify patients of appointments.
• Ensure documentation is completed for insurance coverage and prior authorization.
• Follow up with patients and outside vendors to close referrals after consultation review by Tulalip Health Clinic and PCP.

Skills

CPT/ICD-9 coding

Medical terminology

EHR/EPIC

Insurance pre-authorization

Scheduling GUI

RPMS

Education

High School Diploma or GED

Tools

EPIC

RPMS

Job description

The Tulalip Tribes

The Tulalip Tribes publicly announces that Indian Preference in hiring shall apply to Tulalip Tribal job opportunities according to our Preference Code.

DEPARTMENT

Clinical Records

JOB SUMMARY

The Referral Specialist will work daily in the EPIC queue for all patient referrals for outside services, and coordinating/notifying patients of appointments. Ensuring that documentation is completed; for insurance coverage, insurance prior authorization, and following I.H.S. /T.C.H.S. guidelines for coverage. Will follow-up with patients and outside vendors to close the referral once consultation is received to the Tulalip Health Clinic and the primary care provider has reviewed.

COMPENSATION

$21.48 hr.

MINIMUM REQUIRED EDUCATION

• High School Diploma or GED equivalent.

MINIMUM RELATED EXPERIENCE

• One (1) year of experience with CPT and ICD-9 coding.
• One (1) year of experience working with medical terminology.
• One (1) year of working in the medical field.
• Six (6) months of experience Electronic Health Record and/or EPIC.
• Six (6) months of experience working with insurance company with pre-authorization.
• Experience with CHS priority guidelines preferred
• Experience working with diverse cultures, specifically Native Americans.
• Experience using a scheduling GUI to assist with workflow preferred
• Experience using RPMS preferred

SKILLS TESTING

• Typing 25 WPM
• Medical Terminology Knowledge

REQUIRED LICENSES/CERTIFICATIONS/PREREQUISITES

• CPR/BLS Certificate. *Will allow six (6) monthto obtain.
• Negative TB Skin Test or chest x-ray.
• HIPAA certificationupon hire.
• Must abide by departments vaccination policy and will need to provide up-to-date immunization records as part of the credentialing process.
• Employment is contingent upon successful completion of a pre-employment background check.

TERMS OF EMPLOYMENT

This is a regular Full-Time position.