Job was saved successfully.
Job was removed from Saved Jobs.
This job is archived
(Archived) Referral Coordinator
Last Updated: 7/12/21
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.
- 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.
Our clinician...