Referral Coordinator - Part Time

Responsibilities:

• Coordinates and monitors daily work flow processes and activities for meeting required referral/insurance deadlines (within 72 hours/or as directed by provider – e.g., Stat/emergent).
• Daily reviews and monitors referral and revenue cycle work queues in order to provide accurate and timely process documentation.
• Serves as the first-line resource for all customers (internal/external) with regards to Insurance and Referrals. Must be knowledgeable in all areas of insurance verification and authorization/referral processes.
• Maintain accurate and current referral log on all patients.
• Serve as liaison for patient with doctor offices with regards to processing referrals. Communication may be via fax/telephone/electronically.
• Review and analyze managed care patient visits and ensure proper documentation of required services.
• Coordinate internal functions and recordkeeping related to managed care organizations to meet compliance.
• In collaboration with staff in Patient Financial Services, ascertain physician credentialing is current and required documentation on file.
• Organizes in-service programs for staff regarding all referral/insurance process/revenue cycle changes and updates.
• Liaison between patient and insurance company to explain to patient what their insurance company requires to meet referral/authorization compliance.
• Must have the ability to communicate in a positive, customer service manner when communicating with all customers or when using Department tools (i.e., telephone, fax, email, voice mail, etc.).
• Exhibits teamwork and excellent customer service skills without exception, at all time for both internal and external customers.
• Collaboratively works with internal/external staff, other physician offices, and outside agencies, to resolve patient questions and complaints regarding referral/insurance issues.
• Maintains knowledge of registration and scheduling processes with the capability of filling in as needed based on office workload or staffing demands.
• As needed, assist behavioral health admissions and revenue cycle teams with assigned tasks.
• Identifies any system dysfunction or discrepancies and reports to Supervisor/Manager, making recommendations for improving current department and hospital-wide procedures.
• Assist with other projects or responsibilities as required by Supervisor/Manager.
• Addresses gaps in care in an attempt to help patients reconcile any remaining health care screenings or surveillances.
• Performs duties in accordance with Penn Medicine and entity values, policies, and procedures
• Other duties as assigned to support the unit, department, entity, and health system organization

Education or Equivalent Experience:

• Bachelor of Arts or Science (Required)
• Education Specialization: Equivalent Experience: •1+ years computer experience •1+ years clerical or clinical experience in a medical practice setting •1+ years medical referral/insurance •1+ years medical terminology •1+ years behavioral health experience