Job Opening
(Date Posted on 12/22/2017)

Job Title:   Referral Specialist - Gastroenterology * Days - 40hrs/wk
Job Info:   Referral Specialist - Gastroenterology * Days - 40hrs/wk

Highest Education Level Required:
High School/GED Or Equivalent
General Summary: Under limited supervision, the Referral Specialist coordinates the referral process for the assigned medical group.  This will include, but not limited to, documentation, tracking, pre-authorizations, certifications and follow-ups, related to all insurance type referrals.  This person works closely with physicians, nursing staff and other clerical staff. Requirements: Two years experience or training in medical office or similar setting and/or prior referral experience.High School education or equivalentMedical terminology requiredAble to work independently and collaboratively with minimal supervisionPossess knowledge of medical records content and sequenceTraining or experiences in ICD-9 CM coding and managed care insurance plansPossess knowledge of appointment scheduling processMust process work with minimal errors within appropriate deadlines and timeframesPossess a high level of interpersonal skillsCommunicate effectively, both verbal and writtenAble to prioritize, maintain accurate records, and work under deadline situationsDemonstrates a professional manner when representing BHCExcellent customer service skillsEssential Functions and Responsibilities:Schedules and coordinates specialist appointments, procedures and tests done internally or externally. Provide accurate documentation and record keeping on referrals, authorizations, and boardings.Relay and/or review referral information in a timely fashion with appropriate clinical areas, physicians, physician office and patients.Monitor guidelines for authorizations and referrals according to payer requirements.Monitor “in network” referrals.Ensures proper insurance authorizations are processed within 48 hours.Ensure the physician provides necessary medical and patient information to referral specialist prior to patient referral.Monitor EPIC orders to ensure provider has entered information correctly.Work closely with central scheduling, pre-reg and O/P for coordination of services.Communicate and collaborate with other members of the health care team to ensure continuity and coordination of services.Interacts with providers when determining referral alternatives.Provides ICD-9 CPT coding on referrals, as needed. Provides information to internal and external customers promoting good public relations and interdepartmental relations. Demonstrate a willingness to promptly meet identified needs in a pleasant and courteous manner.Educate physician and staff, when necessary.Identify and address referral issues as they arise. Manage incoming phone calls, performs associated functions and follow up. Answer telephone in a timely manner.Maintain appropriate notes for referrals, phone calls and documents in EPIC.Respond to messages left on referral queue line.Use good telephone etiquette when answering phones, identifying self by name, title, and area. Participate and work effectively as a team member ensuring continuity and coordination of services. Attend and participate in all mandatory meetings, in-services, and staff meetings.Complete required Corporate Compliance / HIPAA education.Is knowledgeable with hospital and departmental policies/procedures and participate in revising as requested.Make suggestions and recommendations for improvement of the referral process.Provide assistance, as needed, and performs other duties as required.Attends meeting as requested to assist with the referral process.Collaborate, communicate, and support team building.Assist areas within MHB office to maintain collaboration and team support.Work with billing office on denials. Maintains a clean, safe and functional working environment. Maintain an organized work area.Takes initiative to notify appropriate person of environmental safety issues/or repairs. Performs other duties as directed by Manager or Director of Medical Education Accept responsibilities willingly.Complete tasks within timeframes requested.Act as superuser for EPIC Customer Service Communicates effectively and positively.Maintains confidentiality/privacy at all times and HIPAA guidelines.Verbal and non-verbal communication demonstrates empathy and concern at all times.Is a role model for other team members.Treat others with dignity and respect.Maintain good public relations. Category: Admin & Clerical
More Info:   Apply Online
Salary:   Competitive
Job Category:   Medical / Health Care

Location:   Wyoming, MI
Type:   Full Time
Contact Person:   Human Resources
Title:   HR

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