Referral Coordinator

3 weeks ago

Canton, United States CareerBuilder Full time

Job Description

Job Description

JOB SUMMARY:
The Referral Coordinator is responsible for initiating and completing internal/external referral requests and providing initial review of benefits and eligibility for services requiring authorization.
ESSENTIAL FUNCTIONS:
Responsible for initiating and completing internal/external, pre-certification referral requests
Reviews patient eligibility and benefits
Assigns appropriate diagnosis and procedure codes following coding guidelines for all referral requests
Aids primary care practitioners and office staff with coding and target review questions
Maintains current knowledge of both coding and targeted review items to ensure that requests are initiated and sent correctly per benefit guidelines and adheres to time frame specified by ELH standards
Ensure coding is completed correctly on all requests to meet all regulatory guidelines and audit standards which will result in compliance and correct reimbursement
Assists and educates patients by answering questions regarding referral and authorization process
Maintains effective communication with physicians and staff as necessary to gather information for referrals as needed
Provides verbal notification in accordance to policy and procedure for patients and providers with respect to the outcome of their requested service
Maintains excellent customer service and professionalism with providers, patients and team members
Any other duties and/or special projects as assigned
QUALIFICATIONS REQUIRED:
High School graduate or equivalent required
Minimum of 1 year experience in the same or similar role
Insurance company/managed care procedural experience preferred
Previous experience with eClinical Works electronic medical records software preferred
We offer our employees a comprehensive benefits package that includes:
Medical insurance with prescription drug coverage
Dental insurance
Vision insurance
Company-paid child care
Company-paid basic life insurance
401(k) with company match
Dependent Care Flexible Spending Account
Healthcare Flexible Spending Account
Paid time off

Company Description At Aylo, weve built a model of healthcare that unlocks the potential of both our patients and those who serve them. Thats why we equip our team with world-class tools and remove many of the administrative tasks that get in the way of caring for patients. Our policies and programs are designed to help discover and unlock your potential by providing opportunities to help you build a healthy and balanced life while advancing your career. It is our belief that by creating a company that cares for you, youll be better equipped to provide that same level of care for our patients. Take the next step towards an exciting and fulfilling career, and unlock your potential to transform the future of healthcare with Aylo Health.

Company Description

At Aylo, weve built a model of healthcare that unlocks the potential of both our patients and those who serve them. Thats why we equip our team with world-class tools and remove many of the administrative tasks that get in the way of caring for patients. Our policies and programs are designed to help discover and unlock your potential by providing opportunities to help you build a healthy and balanced life while advancing your career. It is our belief that by creating a company that cares for you, youll be better equipped to provide that same level of care for our patients. Take the next step towards an exciting and fulfilling career, and unlock your potential to transform the future of healthcare with Aylo Health.
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