Insurance Referral Coordinator
1 week ago
Hours of operation are Monday through Thursday from 7:30 AM to 8:00 PM, Friday from 7:30 AM to 5:00 PM, with rotating Saturdays.
Job Responsibilities
WORK HOURS: 40 hours per week - Monday through Thursday from 7:30 AM to 8:00 PM, Friday from 7:30 AM to 5:00 PM, with rotating Saturdays.
POSITION SUMMARY: The role involves planning, organizing, directing, and coordinating all functions of the referral office.
KEY RESPONSIBILITIES: Qualified candidates must possess the ability (with or without reasonable accommodation) to perform the following tasks:
- Oversee and manage daily workflow processes to meet necessary referral and insurance deadlines (within 72 hours or as directed by the provider).
- Conduct daily reviews of the referral work queue to ensure accurate and timely documentation of the referral process.
- Act as the primary resource for all customers (internal and external) regarding insurance and referrals, demonstrating knowledge in insurance verification and authorization processes.
- Maintain an accurate and up-to-date referral log for all patients.
- Serve as a liaison between patients and healthcare providers regarding referral processing, utilizing various communication methods.
- Analyze managed care patient visits to ensure proper documentation of required services.
- Coordinate internal functions and recordkeeping related to managed care organizations to ensure compliance.
- Collaborate with staff in Patient Financial Services to ensure physician credentialing is current and that required documentation is on file.
- Organize training sessions for staff on changes and updates to referral and insurance processes.
- Facilitate communication between patients and insurance companies to clarify requirements for referral and authorization compliance.
- Communicate positively and effectively with all customers using various departmental tools (telephone, fax, email, etc.).
- Exhibit teamwork and exceptional customer service skills consistently for both internal and external customers.
- Work collaboratively with internal and external staff, other physician offices, and outside agencies to resolve patient inquiries and complaints regarding referral and insurance matters.
- Maintain knowledge of registration and scheduling processes, with the ability to assist as needed based on office workload or staffing requirements.
- Assist the Billing Coordinator with assigned tasks as necessary.
- Provide educational sessions to resident physicians and staff.
- Identify any system dysfunctions or discrepancies and report them to the Supervisor/Manager, making recommendations for improvements.
- Assist with other projects or responsibilities as assigned by the Supervisor/Manager.
- Address gaps in care to help patients reconcile any outstanding healthcare screenings or surveillances.
- Outreach to patients expressing a desire for a new primary care provider to schedule appointments.
- Perform other duties as assigned.
MINIMUM REQUIRED QUALIFICATIONS:
- High school diploma or equivalent
- One (1) year of computer experience
- One (1) year of clerical or clinical experience in a medical practice setting
- One (1) year of experience in medical referral and insurance processes
- One (1) year of experience using medical terminology
- Basic keyboarding skills and telephone/interpersonal etiquette are required. Successful completion of customer service training or equivalent experience is also required.
Lancaster General offers the following benefits to employees:
- 100% Tuition Assistance at The Pennsylvania College of Health Sciences
- Paid Time Off and Paid Holidays
- Shift, Weekend, and On-Call Differentials
- Health, Dental, and Vision Coverage
- Short-Term and Long-Term Disability
- Retirement Savings Account with Company Matching
- Child Care Subsidies
- Onsite Gym and Fitness Classes
Lancaster General is an Equal Opportunity Employer, committed to building a diverse workforce. All positions will be filled based on qualifications without regard to race, color, sex, sexual orientation, gender identity, national origin, marital status, veteran status, disability, age, religion, or any other classification protected by law.
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