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(Archived) Referral Coordinator

Last Updated: 5/29/21

Job Description

Referral Coordinator/Insurance Verification

Responsibilities:

  • Prioritize and process all incoming referrals for designated regions.
  • Obtain all appropriate information and documentation to process the referral.
  • Obtain any other pertinent medical information about the patient for the clinician.
  • Work with the nursing home and/or family to determine if the resident has Medicare, Medicaid or a supplemental insurance.
  • Ensures quality and accuracy of the patient insurance information, and that listed patient demographics, certification periods, billing addresses, policy numbers, authorization numbers, etc. are all entered correctly.
  • Verify Medicare, Medicaid, or Commercial Insurance, via telephone or online systems. Re-verify all insurance monthly for referrals that are still in process.
  • Obtain necessary written or verbal consent for services either by phone, email, or mailing the form to the designated financial responsible party.
  • Ensure all referral documentation is uploaded in the patient’s chart.
  • Serve as a resource for questions regarding referrals.
  • Maintain current information for critical referral contacts for all your assigned regions.
  • Notify clinicians when referrals are ready to be seen (RTBS).
  • Respond to calls, emails and other inquiries regarding the status of outstanding referrals within one business day.
  • Communicate efficiently, effectively, and timely to resolve issues pertaining to referrals.
  • Attend monthly staff meetings.
  • Assists co-workers when necessary.
  • Other duties as assigned.
Qualifications:
  • 2+ years experience of related healthcare experience with the insurance verification & processes. Referral & Authorization experience is a plus.
  • Must know the difference from HMO/PPO/MCO plan when pulling up CSNAP to verify Medicare.
  • Strong organization skills & the ability to multi-task and work independently.
  • Understanding of medical terminology and clinical documentation.
  • Assures confidentiality of all information. Demonstrates knowledge of standards, policies and procedures, operating instructions, confidentiality standards, and the code of ethical behavior.
  • The ability to meet deadlines, create and follow work plans, while maintaining flexibility, is a must.
  • Must be able to resolve conflict, coordinate, listen, work independently as well as work as a team player on various projects.
  • The applicant must be personable and able to communicate well with administrative and clinical staff, both in writing and verbally.
  • High energy, flexible, optimistic attitude with ability to handle multiple demands.
  • Proven attention to detail and promotes a commitment to quality.
  • Must be proficient in the following software: Microsoft Word, Microsoft Excel, Microsoft Access, and Outlook.
  • Minimum High School Diploma or equivalent

Company Details

San Antonio, Texas, United States
The Deer Oaks Difference Since 1992, Deer Oaks has been the nation’s leading long-term care focused behavioral health provider. Being clinician owned and operated has kept us grounded and focused on proactively addressing the need for consistent on-site care in long-term care and assisted living communities while always putting our patients and partnering facilities’ interests first....