- The Scheduling and Referral Specialist obtains authorizations from managed care insurance companies for patient referrals to in-network specialists and in office surgical procedures. The position schedules outpatient and inpatient procedures and communicates necessary prep information, collection of co-pays and deductibles, and pre-registration to patients.
JOB DUTIES AND RESPONSIBILITIES
- Develop a robust understanding of the medical area assigned applying specialized system knowledge necessary for supporting the organization.
- Answer the telephone, schedule appointments and greet patients, providing excellent customer service.
- Initiate telephone and/or written requests to managed care insurance carriers and obtain authorization for referrals prior to patient's scheduled appointment with specialist, radiology or for procedures. Provide documentation of authorization obtainment and maintain referral and authorization records.
- Counsel patients in the office, and over the telephone, regarding the referral requirements of their insurance carrier.
- Receive and process payments from patients for professional services. File medical record documents and maintain medical records. Assume information management responsibilities.
- Communicate changes in patient condition to the physician.
- Use and demonstrate the principles of infection prevention, reduction, and control as appropriate for the medical office setting.
- Notify management of changes in workload to maximize productivity.
- Interact appropriately, professionally and compassionately with patients, patient families, co-workers, other physician offices, hospital department personnel and all other entities.
- Other duties as assigned.
JOB REQUIREMENTS
EDUCATION AND EXPERIENCE
Level of Education
Minimum Required: High School Diploma
Preferred: Coursework in Medical Terminology and/or Medical Certification Program
Level of Experience
Minimum Required: Two (2) years experience in a healthcare setting performing related tasks.
Preferred: Five (5) years of experience in a healthcare setting performing related tasks.
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