Healthcare Referral Specialist

5 days ago

Beverly Hills, California, United States ThreePDS Inc. Full time
About the Role:

The Referral Coordinator is responsible for all administrative processing in regard to patient's personal and insurance information for a group of dialysis clinics.

This individual cooperates and works closely with both internal and remote co-workers, possesses strong time management skills and the ability to complete assigned job duties with applicable supervisory direction, including exercising job appropriate judgement.

Essential Functions:

  • Processes new patient referrals through internal Central Registration System (CRS), ensuring accuracy of patient personal and insurance information.
  • Completes insurance benefit verifications via phone or online verification tools to confirm patient benefits, specific to the referred clinic, to determine acceptance to the clinic.
  • Works with clinic staff to ensure proper documentation for patient verifications is obtained.
  • Works with clinic staff to obtain patient and/or representative signatures on admission documentation as needed.
  • Acts as first point of contact for patient's benefit or network status questions. Escalates difficult conversations as necessary.
  • Ensures completeness and accuracy of patient accounts in billing system, QMS.
  • Resolves billing rejections related to patient demographic information, including working with the patient and/or payer for resolution if necessary.
  • Educates patients on financial responsibility while travelling internationally and drafts corresponding agreements for signature.
  • Initiates requests for authorization as needed based on insurance requirements and clinic network status.
  • Completes and maintains region and/or clinic specific reports.
  • Ensures compliance with CMS coordination of benefits rules.
  • Ensures confidentiality of all data, including patient, employee and operational data.
  • Adapts and is flexible when change arises, alternating between tasks as needed.
  • Stays current with department changes and updates and willingly learns new skills.
  • Handles patient information with discretion and sensitivity and maintains HIPAA compliance.
  • Understands and complies with Medicare rules and regulations, as well as applicable federal, state, agency, region and clinic rules and regulations.

Requirements:

  • Bachelor's degree- REQUIRED
  • 2 years of experience in similar administrative setting (referral coordinator/benefits coordinator/admissions coordinator)- REQUIRED
  • Must be willing and serious about going direct after the 13 week travel assignment

About the Facility:

We offer starting salaries above the industry average, and we do not cap salaries.

Our annual raises are significantly above the industry standard.

We recognize your most recent dialysis experience in calculating your paid time off accrual allowing your transition to ARA to be easy without effecting valuable time off.

This facility is one of the largest dialysis service providers in the United States.

We provide quality patient care to patients suffering from the most advanced state of chronic kidney disease, known as End Stage Renal Disease (ESRD).

We continue to expand our network of dialysis centers and improve more lives year.

Apply to become part of a team who is focused on quality patient care

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