Referral and Pre-Certification Coordinator

3 days ago


Knoxville, Tennessee, United States Covenant Health Full time

Job Summary:

Covenant Health is seeking a highly organized and detail-oriented Referral and Pre-Certification Specialist to join our team. As a key member of our scheduling department, you will be responsible for directing the daily operation of scheduling for inpatient and outpatient procedures and services.

Key Responsibilities:

  • Schedule inpatient and outpatient tests, procedures, and appointments as directed by providers, ensuring accurate documentation in the medical record file.
  • Accurately complete all forms required for referrals and pre-certifications, adhering to insurance plan guidelines and regulations.
  • Maintain accurate testing, referral, and appointment logs, with follow-up verification in the referral tracking database.
  • Utilize knowledge of ICD-9 and CPT coding, as well as basic computer skills, to efficiently manage scheduling tasks.
  • Coordinate dates, times, and locations of procedures/appointments with patients, facilities, and providers.
  • Communicate appointment details and special instructions to patients, ensuring seamless scheduling experiences.
  • Report any issues obtaining referrals, pre-certifications, or appointments as ordered by providers.
  • Perform additional duties as assigned or requested, contributing to the overall success of the scheduling department.
  • Attend meetings and participate on committees as required, fostering collaboration and teamwork within the organization.
  • Work closely with patients, physicians, and other care team members to provide exceptional patient care.

Requirements:

  • High school diploma or equivalent required; preference given to individuals with prior experience in referral and pre-certification roles.
  • Previous experience in medical terminology and scheduling a plus.
  • Basic computer skills and knowledge of ICD-9 and CPT coding essential.


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