Referral Coordinator - Healthcare for Women Villa Rica (Days)

Job Title

Duties include but are not limited to verifying insurance benefits, establishing payment plans, informing patients of appointment times for procedures, calling patients after procedures, and scheduling additional tests as needed. Will work practice front desk and phones as needed.

Education

High School Diploma or GED

Experience

One year of related experience.

Qualifications

*One-year previous collection experience required

*Working knowledge of CPT and ICD-9 coding is required.

*Ability to organize, analyze and prioritize work

*Data entry experience preferred. Business like appearance. Detail-oriented. Ability to multitask. Ability to work closely with others and function as a team member

*Exhibit exceptional communication skills

*Must possess the initiative and drive to take a project from beginning to a successful completion

Area of Responsibilities

*Customer Service: Provides customer service functions to include addressing patient inquiries and complaints from all sources in a timely manner. Initiates necessary corrections to patient accounts and attempts to repair damage done to relationship with patient. This will require interaction with co-workers, physician offices and insurance carriers. Success indicated by problems being resolved by team member requiring little director intervention. Participates in patient satisfaction initiatives. Demonstrates excellent customer service skills Communicates effectively with patients and management regarding service recovery opportunities. Works together with other team members to achieve Office and System customer service goals

*Development: Maintains a current knowledge of TMG Billing and Collection Procedures as well as clinic policies. Develops and maintains a high level of expertise in collection rules and regulations by reading and studying all applicable bulletins, newsletters, etc?Develops and maintains a working knowledge of CPT and ICD coding. Participates in continuing education Participates in the development of new programs

*Referral Coordinator duties: Schedules outpatient procedures and referrals. Obtains pre-certification/prior authorizations for procedures, outpatient tests, and referrals. Prepares charts prior to procedures. Informs patients about procedure prep and clearance. Ensures informed consents are signed with 30 days of procedure. Confirms procedure schedule with physician(s), surgical department and other departments as necessary. Performs post-procedure call backs per physician instructions. Indicates follow-up calls to patients by entering detailed comments in the medical record. Responsible for verifying insurance information/benefits as needed for procedures. Responsible for establishing payment plans and notifying patients of any insurance problems. Works with others in the department to solve problems and make process improvements. Prepares productivity reports each month, including but not limited to procedure and follow up calls made. Assists with special projects as needed. Responsible for verifying insurance information/benefits as needed. Serves as TMG contact for information needed within the practice. Works rejections/denials on a daily basis and re-bills as needed. Assists in education of front office staff to reduce denials. Maintains strict confidentiality.

*Safety: Maintains working knowledge of equipment and removes faulty equipment from use as necessary. Participates in safety programs

*Teamwork: Works well with others and functions as a team player. Offers ideas and solutions for issues that affect the team and work area. Stocking and ordering of supplies as needed Maintains patient care areas. Participates in the training and skills development of new front office employees. Assists in other areas of the office as necessary

*Other duties as assigned.

Compliance Statement

Employee performs within the prescribed limits of Tanner Health System's Ethics and Compliance program. Is responsible to detect, observe, and report compliance variances to their immediate supervisor, the Compliance Officer, or the Hotline.

Education

High School Diploma or GED

Experience

One year of related experience. Requires a working knowledge of standard practices and procedures.

Licenses & Certifications

*NONE REQUIRED

Supervision

*Exercises no supervisory duties.

Qualifications

*Ability to organize, analyze and prioritize work

*Data entry experience preferredBusiness like appearanceDetail orientedAbility to multi-taskAbility to work closely with others and function as a team member*Exhibit exceptional communication skills*Must possess the initiative and drive to take a project from beginning to a successful completion*One-year previous collection experience required *Working knowledge of CPT and ICD-9 coding required

Definitions

*Will serve as a Referral Coordinator and address a variety of responsibilities. Responsible for verifying insurance coverage and establishing payment plans as necessary for procedures. Will be responsible, primarily, for scheduling patient procedures. Duties include but are not limited to verifying insurance benefits, establishing payment plans, informing patients of appointment time for procedures, calling patients after procedures and scheduling additional tests as needed.

Contact With Others

Requires frequent contact with many persons at different levels inside and outside of the organization to carry out organization policies and programs and obtain willing acceptance, consent, or action.

Effect Of Error

Probable errors may be serious and involve losses such as improper costs, overpayment, waste of material, damage to equipment, and delay in processing work. Effect usually confined within the organization. Most of work not subject to direct verification or check. Regularly works with some confidential data such as account, salaries, patient medical records, which if disclosed might have adverse internal or external effects.

Supervisory Responsibility

Exercises no supervision, work direction, or instruction of other employees or students

Mental Demands

Assignment requires planning and arranging own work to reach definite objectives. Applies knowledge of a specific field using several varied procedures or techniques. Solves non-routine technical, treatment, or operational problems under general guides

Physical Effort

Moderate physical effort - Lifts, carries, or handles lightweight (1 to 25 lbs.) materials or equipment for about half of the day. Very occasional physical effort with medium weight objects (25- 60 lbs.). Office or laboratory work requires close visual effort and concentration more than half of day. Works in reaching or strained positions for less than half of day.

Working Conditions

Minor - Occasionally involved in exposure to dirt, odors, noise, or some work is performed with exposure to temperature/weather extremes/occupational risk and probability of coming into contact with blood borne pathogens, other potentially infectious diseases, or biomedical/bio-hazardous materials.

Working Conditions Aspects For Immunizations

*Performs tasks involving contact with blood, blood-contaminated body fluids, other body fluids, or sharps (needles)

Physical Aspects

Continually (at least once per day)*Hearing*Visual Frequently (at least 3 times a week)*Typing*Manual Dexterity ? picking, pinching With fingers etc.*Speaking*Standing*Walking*Lifting up To 25 lbs.*Carrying Occasionally (at least once a month)*Bending*Feeling (Touch)? determining temperature, texture, by touching*Reaching ? above shoulder*Reaching? below shoulder*Color Vision*Balancing*Running - In response To an emergency*Lifting 25 To 60 lbs.*Lifting over 60 lbs.*Handling? seizing, holding, grasping*Climbing*Kneeling*Squatting*Driving? Class C vehicles*Pushing/Pulling? up To 25 lbs.*Pushing/Pulling? 25 To 60 lbs.*Pushing/Pulling? over 60 lbs.