Healthcare Referral Manager

2 weeks ago

Hillsboro, United States Hillsboro Medical Center Full time

POSITION OVERVIEW

The Patient Care Coordination Specialist plays a vital role in overseeing patient referrals and authorization processes in alignment with various insurance policies. This position encompasses a diverse range of responsibilities, including effective communication via phone, insurance management, front desk operations, and appointment scheduling. The specialist is tasked with ensuring that all necessary information is accurately collected and documented for referrals and authorizations, while also delivering exceptional customer service, such as verifying insurance coverage and coordinating appointments.

PRIMARY DUTIES

  • Facilitates the processing of referrals and authorizations for consultations, diagnostic tests, and medical procedures in accordance with insurance guidelines.
  • Secures authorization for both prescription and infusion medications.
  • Manages the sample medication program and oversees medication storage within the clinic.
  • Assists patients with co-payment and medication assistance programs.
  • Prepares and forwards medical documentation to external parties and referring physicians.
  • Confirms insurance eligibility for patient visits to healthcare providers.
  • Handles incoming phone inquiries, prioritizes calls, and retrieves prior medical records as needed.
  • Updates and maintains patient demographic and financial information.
  • Manages correspondence and ensures daily mail distribution.

QUALIFICATIONS

Education:

Preferred

  • Completion of high school or equivalent (GED).

Experience:

Preferred

Licenses, Certifications, and/or Registrations:

Preferred

  • Current Basic Life Support (BLS) certification.

Essential Skills and Attributes:

Required

  • Exhibits a professional demeanor and conduct.
  • Possesses strong communication and customer service abilities.
  • Demonstrates excellent organizational and multitasking skills.
  • Has a solid understanding of medical terminology, insurance protocols, and coding practices.
  • Proficient in personal computer operations while maintaining confidentiality.

Additional Information

Hillsboro Medical Center is dedicated to fostering equal employment opportunities for all qualified candidates. Recruitment, hiring, promotions, transfers, and compensation decisions are made based on qualifications without regard to race, gender, religion, age, national origin, or any other protected status. Our policy promotes fair treatment and equal opportunities for all employees.

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