Referral Coordination Specialist

2 weeks ago


San Antonio, Texas, United States Christus Health Full time

Position Overview:

The role of the Referral Coordination Specialist involves overseeing the complete referral process within a medical practice. This includes acquiring orders from physicians, securing insurance authorizations from payors, and scheduling patient appointments with physicians who accept specific insurance plans. The coordinator will also inform patients about their appointments and manage renewal authorizations with both the physician's office and the insurance provider.

Key Responsibilities:

  • Research and resolve issues related to referral claims or payment requests.
  • Ensure accurate coding and diagnosis from physicians to facilitate proper referrals and insurance coverage.
  • Maintain comprehensive knowledge of various insurance plans and their coverage to guarantee appropriate payment.
  • Educate nursing staff and physicians on updates and changes in insurance plans related to referrals and authorizations.
  • Stay current with all relevant CPT and ICD-9 coding practices to ensure accurate processing of referrals.
  • Utilize clinical knowledge to effectively communicate with insurance companies regarding referrals.

Qualifications:

  • High School Diploma or equivalent is mandatory.
  • A minimum of 3 years of experience in an office environment within the healthcare sector is required.
  • Extensive knowledge of managed care benefit plans, with at least 1 year of experience in a referral-focused clinic or physician's office.
  • Medical assistant certification from an accredited technical institution is preferred.

Employment Type:

This position is offered on a full-time basis.

Equal Employment Opportunity:

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