Referral Specialist Cardiology

Banner Medical Group; Chandler (AZ); On-site; USD 42,000 - 58,000; Full time

Job summary

Banner Medical Group is seeking a Referral Specialist for Cardiology in Chandler, AZ. You will coordinate referral orders for continued care, gather necessary clinical information for payor authorization, and track referrals to close patient care gaps.

This role emphasizes clear communication with patients, providers, and payers. The position requires HIPAA knowledge, strong customer service, and the ability to manage multiple priorities in a healthcare setting.

Qualifications

• High school diploma or GED required.
• 1 year of direct patient interaction/experience in medical, insurance, or healthcare setting.
• Knowledge of HIPAA regulations.
• Strong customer service focus and problem-solving.
• Excellent verbal and written communication; ability to handle multiple priorities.
• Proficiency with commonly used office software.

Responsibilities

• Schedule appointments for specialty physician services and diagnostic testing per provider requests.
• Act as liaison between patients, providers and staff for referral and follow-up needs.
• Provide clinical information for payor authorization and prior to services.
• Track referrals and follow up with patients to close care gaps.
• Maintain knowledge of medical terminology and insurance regulations.
• Collaborate with outside referral sources and community resources.
• Communicate with patients, physicians, staff and payers and prioritize tasks.

Skills

Customer service

Verbal communication

Written communication

Time management

MS Office

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Primary City/State: Chandler, Arizona Department Name: East Valley Cardiology-Clinic 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 Multispecialty clinic, where you’ll be working side by side with medical staff to create a great patient experience. As a Referral Specialist for Cardiology, you will have an opportunity to work with a wonderful team helping patients. You will have regular opportunities to learn new things and utilize your exceptional customer service skills to make a difference in the lives in our patients. 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.

Shift: Monday-Friday 8:30am-5pm Location: 1125 S. Alma School Rd. Ste 310. Chandler, AZ 85286

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. 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. 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. 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. 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. 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. 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. 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.

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Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better.

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