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Insurance Referral Coordinator

2 months ago

Columbia, Pennsylvania, United States Lancaster General Full time
Overview
Our operational hours are Monday through Thursday from 7:30 AM to 8:00 PM, Friday from 7:30 AM to 5:00 PM, with rotating Saturdays.

Position Overview

HOURS: 40 hours per week - Operational hours are Monday through Thursday from 7:30 AM to 8:00 PM, Friday from 7:30 AM to 5:00 PM, with rotating Saturdays.

POSITION SUMMARY: Responsible for planning, organizing, directing, and coordinating all facets of the referral office.

KEY RESPONSIBILITIES: Qualified candidates must possess the ability (with or without reasonable accommodation) to perform the following tasks:
  • Oversee and manage daily workflow processes to meet necessary referral and insurance deadlines (within 72 hours or as directed by the provider, including urgent cases).
  • Conduct daily reviews of the referral work queue to ensure accurate and timely documentation of the referral process.
  • Act as the primary resource for all customers (internal and external) regarding insurance and referrals, demonstrating knowledge in insurance verification and authorization/referral processes.
  • Maintain an accurate and up-to-date referral log for all patients.
  • Serve as a liaison between patients and physician offices concerning referral processing, utilizing fax, telephone, or electronic communication.
  • Analyze managed care patient visits and ensure proper documentation of required services.
  • Coordinate internal functions and recordkeeping related to managed care organizations to ensure compliance.
  • Collaborate with staff in Patient Financial Services to verify that physician credentialing is current and that required documentation is on file.
  • Organize training sessions for staff regarding updates and changes in referral and insurance processes.
  • Act as a liaison between patients and insurance companies to clarify requirements for referral and authorization compliance.
  • Exhibit positive communication skills in a customer service manner when interacting with all customers or utilizing departmental tools (e.g., telephone, fax, email, voicemail).
  • Demonstrate teamwork and exceptional customer service skills consistently for both internal and external customers.
  • Work collaboratively with internal/external staff, other physician offices, and outside agencies to resolve patient inquiries and complaints related to referral and insurance issues.
ADDITIONAL RESPONSIBILITIES: The following tasks are considered secondary to the primary responsibilities listed above:
  • Maintain knowledge of registration and scheduling processes, with the capability to assist as needed based on office workload or staffing demands.
  • Assist the Billing Coordinator with assigned tasks as required.
  • Provide educational sessions to resident physicians and staff.
  • Identify any system issues or discrepancies and report them to the Supervisor/Manager, offering recommendations for improving current departmental and hospital-wide procedures.
  • Assist with other projects or responsibilities as assigned by the Supervisor/Manager.
  • Address gaps in care to help patients reconcile any outstanding health care screenings or surveillances.
  • Outreach to patients expressing a desire for a new primary care physician to schedule appointments, as well as those who have not been seen in the past 18 months to maintain their healthcare relationships.
  • Other duties as assigned.
QUALIFICATIONS

MINIMUM REQUIRED QUALIFICATIONS:
  • High school diploma or equivalent.
  • One (1) year of computer experience.
  • One (1) year of clerical or clinical experience in a medical practice setting.
  • One (1) year of experience in medical referral and insurance processes.
PREFERRED QUALIFICATIONS:
  • One (1) year of experience using medical terminology.
  • Basic keyboarding skills and telephone/interpersonal etiquette are required. Successful completion of a customer service training module or equivalent experience with successful completion of related competency testing is also required.
Benefits Overview:

Lancaster General offers a comprehensive benefits package to employees, including:
  • 100% Tuition Assistance at The Pennsylvania College of Health Sciences.
  • Paid Time Off and Paid Holidays.
  • Shift, Weekend, and On-Call Differentials.
  • Health, Dental, and Vision Coverage.
  • Short-Term and Long-Term Disability.
  • Retirement Savings Account with Company Matching.
  • Child Care Subsidies.
  • Onsite Gym and Fitness Classes.
Equal Opportunity Statement

Lancaster General is an Equal Opportunity Employer, committed to building a diverse workforce. All positions will be filled based on qualifications without regard to race, color, sex, sexual orientation, gender identity, national origin, marital status, veteran status, disability, age, religion, or any other classification protected by law.