Referral Coordinator

19 hours ago


Charlottesville, Virginia, United States Commonwealth of Virginia Full time
Job Description

We are seeking a highly skilled Referral/Billing/Reimbursement Coordinator to join our team at the Commonwealth of Virginia.



Key Responsibilities

  • Manage referrals for Radiation Therapy Services, ensuring efficient and effective processes.
  • Provide high-level customer service to referring physicians and patients, verifying medical necessity for radiation treatments.
  • Apply and interpret policies and procedures, using independent judgment in a medical setting.
  • Maintain a working knowledge of carrier contracts, changes, and departmental policies and procedures.
  • Complete referral forms accurately and enter necessary information into Epic.
  • Notify team members of pending referrals and inform patients of referral responsibilities.
  • Coordinate with financial coordinators and review insurance guidelines to determine eligibility for treatment.
  • Consult with physicians to gather additional information for medical necessity determinations.
  • Maintain thorough knowledge of insurance company criteria and radiation-specific billing codes.
  • Ensure accurate pre-certification and authorization information is aligned with billing.
  • Advocate for patients, navigating the system to ensure efficient care.
  • Develop tools to assess patient referral processes for efficiency and customer service.


Requirements

  • High School Diploma.
  • 2 years of relevant experience.
  • Relevant coding certification, such as Radiation Oncology Certified Coder (ROCC), strongly preferred.
  • Strong communication and problem-solving skills.
  • Ability to maintain confidentiality and handle sensitive information.


Physical Demands

This is a primarily sedentary role involving extensive use of desktop computers. Some travel may be required for meetings and programs.



Equal Opportunity Employer

The Commonwealth of Virginia is an equal opportunity employer, committed to diversity and inclusion. We welcome applications from qualified candidates of all backgrounds.



Compensation Range

$19.11 - $29.62 Hourly.




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