Pediatric Referral and Insurance Coordinator
2 weeks ago
Ranken Jordan Pediatric Bridge Hospital is seeking a highly skilled Referral and Insurance Specialist to join our team. As a key member of our outpatient services team, you will play a critical role in ensuring the effective management of all incoming referrals for outpatient services and the transition of inquiries to the appropriate service lines within our hospital.
Responsibilities:
- Receiving and reviewing OP service referrals, transitioning inquiries to appropriate service lines.
- Verification and documentation of insurance information for all federal and commercial plans; in/out of network benefits and options prior to initial date of service and monthly for recurring outpatients.
- Determine patient's financial responsibilities as indicated by insurance and accurately document all findings in the EMR. Up-front collection of co-pays, deductibles, and co-insurances as needed. Referrals to financial services as needed for financial assistance.
- Works closely with the OP Therapy Manager and the OP Coordinator to optimize scheduling and workflow. As-sists with various other duties as assigned, including but not limited to, assist in processing appeals for additional services (extended stays, visits, authorization extension, letter of medical necessity) and referrals to additional resources when necessary. Coverage for OP Coordinator as needed. Assist in the development, organization and maintenance of role specific documents, policies, and tools.
Requirements:
- Strong communication and customer service skills; excellent organizational and time management skills; the ability to prioritize multiple tasks; work independently; demonstrated clerical and organizational skills; knowledge of medical terminology; and proficiency with the MS Office suite required.
- Previous experience with admission and benefit eligibility verification processes preferred.
- Requires extensive time performing on-line verification and authorization requests. In addition, may require extended periods on phone performing insurance verification and authorization requests.
Physical Demands:
These include stooping, kneeling, crouching, reaching, grasping, pulling, pushing, standing, carrying, and lifting light loads (up to 35 lb.).
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Pediatric Referral Coordinator
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Maryland Heights, Missouri, United States Ranken Jordan Pediatric Bridge Hospital Full timeJob Title: Pediatric Referral and Insurance SpecialistRanken Jordan Pediatric Bridge Hospital is seeking a highly skilled Pediatric Referral and Insurance Specialist to join our team.Job Summary:The Pediatric Referral and Insurance Specialist is responsible for ensuring the effective management of all incoming referrals for outpatient services and the...
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