Patient Referral Specialist

1 week ago


Reno, Nevada, United States Center for Orthopedic and Research Excel Full time
Job Overview

The Referral Coordinator plays a crucial role in ensuring the smooth operation of patient referrals within the healthcare system. This position involves meticulous management of patient information and coordination with various healthcare providers.


Key Responsibilities
  • Ensure accurate verification and updating of patient registration details in the practice management system.
  • Obtain necessary authorizations and benefit verifications for all outpatient visits, procedures, and services.
  • Utilize online verification systems to confirm insurance eligibility with precision.
  • Generate and manage referrals for pending patient visits.
  • Verify and update patient demographic and insurance information to facilitate claims processing.
  • Prepare charts daily to enhance the patient check-in experience.
  • Conduct thorough research to gather necessary information for patient registration.
  • Efficiently fax referral forms to providers as needed, managing a high volume of referrals daily.
  • Notify front office staff regarding outstanding patient balances.
  • Maintain productivity standards and ensure timely claims reimbursement.
  • Address inquiries from providers and support staff regarding patient referrals and care coordination.
  • Identify and report trends or potential issues to management.
  • Index referrals accurately to patient accounts and create new accounts for non-established patients.

Qualifications
  • High school diploma or equivalent preferred.

Experience
  • Two to three years of experience in a healthcare setting, particularly in referral management or front desk roles.
  • Effective communication skills with the ability to build strong relationships with patients and healthcare professionals.
  • Familiarity with Centricity Practice Management and Centricity EMR is advantageous.

Requirements
  • Experience with managed care insurances, including the referral and authorization processes.
  • Comprehensive understanding of insurance plan requirements for Medicaid and commercial plans.

Knowledge and Skills
  • Proficient in eligibility verification and prior authorization processes.
  • Knowledge of billing guidelines and government provisions.
  • Advanced computer skills, including proficiency in Windows-based applications.
  • Ability to manage challenging situations with professionalism and maintain a positive demeanor.
  • Strong organizational skills and attention to detail.

Work Environment
  • Standard office environment with typical physical and mental demands.
  • Requires sitting and standing, along with some manual dexterity for computer use.

Organizational Commitment
  • Adherence to the mission, vision, and values of the organization is essential.


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