Referral Coordinator

2 days ago


Waukegan, Illinois, United States Vista Health System Full time
About the Role

Vista Health System is seeking a highly skilled Referral Coordinator to join our team. As a key member of our healthcare team, you will be responsible for ensuring accurate and timely verification of insurance for patients being admitted into our hospital for care.

Key Responsibilities
  • Pre-verify insurance coverage for patients to ensure reimbursement.
  • Resolve insurance coverage issues and escalate complex cases to supervisors or managers.
  • Interview patients and complete necessary paperwork to ensure efficient admitting processes and compliance with hospital and regulatory policies.
  • Review daily Alpha Census & Admissions Register to determine pre-certification needs.
  • Verify accurate financial and demographic data and documentation for hospital admissions.
  • Work with Utilization Review (UR) to coordinate PPO, Medicaid, and Medicare information to prevent denials and delays.
  • Maintain department records, reports, and files as required.
  • Collaborate with physician offices to obtain required authorization for procedures from different payors.
  • Verify insurance benefits for scheduled outpatient services.
Requirements
  • High School Diploma or equivalent education.
  • Two years of experience in a hospital or medical-related environment, with knowledge of insurances and the insurance industry.
  • Minimum one year of customer service experience.
  • Knowledge of computers and standard office equipment.


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