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Referral Coordination Specialist
2 months ago
Position Overview:
The role of the Referral Coordination Specialist is crucial in managing the comprehensive referral process within a medical practice. This includes tasks such as securing orders from physicians, obtaining necessary insurance authorizations, scheduling patient appointments with participating physicians, and informing patients about their appointments. Additionally, the specialist will handle renewal authorizations with both the physician's office and the insurance payor.
Key Responsibilities:
- Investigate and resolve issues related to referral claims or payment requests.
- Ensure accurate coding and diagnosis by physicians to facilitate appropriate referrals and insurance coverage.
- Maintain a thorough understanding of various insurance plans and their coverage to guarantee proper payment.
- Educate nursing staff and physicians on updates regarding insurance plans and the referral and authorization processes.
- Stay current with all relevant CPT and ICD-9 coding to ensure correct referral processing.
- Utilize clinical knowledge to effectively communicate with insurance companies regarding referrals.
About CHRISTUS Health:
CHRISTUS Children's Hospital has been a pioneer in pediatric healthcare since its establishment in 1959. As the first children's hospital in South-Central Texas, it serves a diverse population of over 70,000 children each year. The hospital is renowned for its specialized services, including Pediatric and Neonatal Intensive Care, Children's Emergency Services, and advanced treatments for various medical conditions.
Qualifications:
- A 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 is a Full-Time position.
Equal Employment Opportunity:
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