Referral Coordinator 2 Jobs

JOB SUMMARY

The Referral Coordinator 2 provides patients, physicians and internal hospital personnel with insurance benefit/ Referral information. This position ensures timely verification of insurance benefits and financial clearance which has a direct impact to the organization's reimbursement from payers for patient accounts that are scheduled and unscheduled. This position assists in addressing more complex issues and managing workflow.

Hours: M-F 8:00am-5:00pm

ESSENTIAL FUNCTIONS OF THE ROLE

• Performs financial clearance of patient accounts by verifying insurance eligibility and benefits and ensuring all notifications and authorizations are completed within the required timeframe.
• Communicates timely with Utilization Review, and partners effectively with physician and facility staff to ensure financial clearance of the patient's account prior to scheduled or unscheduled service during the patient's hosptial stay.
• Documents systems according to the Insurance Verification guidelines to assure accurate and timely reimbursement.
• Calculates accurate patient financial responsibility.
• Assists co-workers, facility customers with complex questions and issues.
• Interprets complex payer coverage information including, but not limited to, network participation status with provider, limited plan coverage and inactive benefits.
• Coordinates the submission of clinical documentation from physicians to payers for authorization needs.
• Manages workflow of specific area to ensure maximum results for department as requested.
• Completes appropriate payor forms related to notification and authorization.

KEY SUCCESS FACTORS

• Excellent data entry, numeric, typing and computer navigational skills.
• Ability to maintain a professional demeanor in a highly stressful and emotional environment, behavioral health and/or suffering patients in addition to life or death situations.
• 2 years of healthcare or customer service experience or education equivalency required.
• Requires good listening and communication skills, and professional telephone etiquette.
• Must have the ability to consistently meet performance standards of production, accuracy, completeness and quality.
• Basic computer skills and Microsoft Office.
• Must be able to exhibit a high level of empathy with the ability to effectively communicate with patients and family members during traumatic events, while demonstrating exceptional customer service skills.
• Demonstrates ability to manage multiple, changing priorities in an effective and organized manner.
• Ability to know and adhere to payer guidelines by plan and service type.

BENEFITS

Our competitive benefits package includes the following

• Tuition Reimbursement
• PTO accrual beginning Day 1
• Immediate eligibility for health and welfare benefits
• 401(k) savings plan with dollar-for-dollar match up to 5%

Note: Benefits may vary based upon position type and/or level

QUALIFICATIONS

• EDUCATION - H.S. Diploma/GED Equivalent
• EXPERIENCE - 2 Years of Experience