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  • ID
    #5118703
  • Salary
    TBD
  • Source
    AdventHealth
  • Date
    2020-10-24
  • Deadline
    2020-12-22

Vacancy expired!

DescriptionReferral Specialist FT Days AdventHealth Sebring Location Address:4200 Sun 'n Lake Boulevard Sebring, FL 33872 Top Reasons to Work at AdventHealth Sebring Faith Based & Mission driven FacilityLargest Employer in the CountySurrounded by beautiful Lakes, Golf Courses and Florida’s oldest State ParkClose knit community with a home town family feel2 hours to just about any beach on either CoastWork Hours/Shift Full Time Days You Will Be Responsible For: Assists patients in a prompt, courteous, and efficient manner.Serves as liaison between the insurance company, the patient and physician office.Directs the patients to the appropriate specialist and vendors according to their insuranceTakes accurate and legible messages, which include time, date and other important detailsAnswers non-clinical questions for patients and routes all other calls correctly.Obtains physician approval for referrals and hospital admissions.Contacts insurance company for referral number or pre-certification/authorization.Schedules outpatient procedures/tests and notifies patient of appointment and referral number the same day it is obtained.Completes referral timely.Utilizes third party payer/insurance portals; has a detailed knowledge of insurance providers, their portals and their expectations for authorization approvalRequests medical records from specialists or hospital to process the referral or hospital authorization.Follows up with the insurance company regarding the status of the authorization.Understands guidelines for and appropriately uses the telephone system QualificationsWhat You Will Need: Minimum of a High School Diploma or EquivalentPhysician office billing, registration or scheduling experienceOne (1) year of ICD-9 and CPT-4 coding experience preferredMedical Assistant preferred Job Summary: The Referral Specialist is responsible for the coordination, processing and scheduling of medical referrals and prior authorizations for a variety of medical or surgical services/procedures for clinic patients, as requested by clinical providers in a centralized call center environment. This requires clinical knowledge and understanding of CPT and ICD-9(10) codes to meet the requirements of third party payers and specialty clinics to ensure minimal delay in securing referral appointments or pre-authorization for multiple providers in multiple locations. Collaborates with other Clinic Referral Specialists, Providers, MA's, Scheduler/Receptionist and other support staff in multiple clinic locations. This position requires the use of clinical and administrative judgment and initiative to determine the best approach for both urgent and non-urgent patient care needs. Processes medical record requests pertaining to the referral itself, obtaining proper authorization as needed. Serves as a liaison between patients and medical office support staff in regards to referrals and appointment scheduling. This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.

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