Referral Specialist - Maternal Fetal Medicine

UCHealth; Colorado Springs (CO); On-site; Full time

Job summary

A leading healthcare provider in Colorado Springs is seeking a full-time position to ensure compliance with insurance requirements and enhance patient flow. The role involves verifying benefits, responding to inquiries, and maintaining confidentiality. Applicants should have a high school diploma and some healthcare experience.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

403(b) with employer matching

Paid Time Off

Life Insurance

Disability Coverage

Wellness Benefits

Education Benefits

Loan Repayment Options

Qualifications

• 6 months' experience in healthcare.

Responsibilities

• Verifies eligibility and benefits; obtains authorizations for treatment.
• Responds to third party payors and maintains information on health plan guidelines.
• Monitors patient needs and prepares written reports.

Skills

Critical Thinking

Decisive Judgment

Education

High School diploma or GED

Associate's degree

Job description

Location:

UCHealth UCHlth Memorial Hosp Central, US:CO:Colorado Springs

Department:

UCHlthMG MFM

FTE:

Full Time, 1.0, 80.00 hours per pay period (2 weeks)

Shift:

Days

Pay:

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

Summary:

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

Responsibilities:

1. Verifies eligibility and benefits; obtains authorizations for treatment or precertification of high cost drugs. Tracks referrals to ensure compliance with guidelines. Tracks formulary requirements.
2. 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.
3. Ensures confidentiality of patient and institutional information. Provides routine information to customers and relays information appropriately.
4. Monitors patient needs and responds to inquiries. Prepares written reports.
5. Works within scope of job, requiring critical thinking, decisive judgment, and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action.

Requirements:

• Minimum Required Education: High School diploma or GED. Preferred: Associate's degree.
• Required Licensure/Certification: None required.
• Minimum Experience: 6 months' experience in healthcare.

Additional Information:

UCHealth offers a comprehensive benefits package, including medical, dental, vision, 403(b) with employer matching, paid time off, life insurance, disability coverage, wellness benefits, voluntary benefits, education benefits, and loan repayment options such as PSLF program assistance.

UCHealth is an equal opportunity employer committed to diversity and inclusion. We welcome talent and are dedicated to making all employment decisions based on valid requirements without discrimination.