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Referral Specialist

Sunset Health

Yuma, AZ

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JOB DETAILS
SKILLS
Copying Machines, Current Procedural Terminology (CPT), Documentation, Fax Machines, HIPAA (Health Insurance Portability and Accountability Act), Housekeeping/Cleaning, ICD-10, Insurance, Legal, Medical Record System, Medical Records, Organizational Skills, Plan Meetings, Productivity Management, Statistics, Time Management
LOCATION
Yuma, AZ
POSTED
20 days ago
  • Handle incoming clinical tasks, phone calls, and in-person requests, reviewing clinical history and obtaining notes for provider when needed; ensuring correct payer, CPT, and ICD-10 codes are on referral requisition.
  • All referrals are processed in a timely and efficient manner and according to the referral policies and procedures; insurance benefit and eligibility is confirmed prior to processing the referral, ensuring patient is assigned to a SH provider.
  • Arrange appointments with external and internal specialties, faxing referral requisition and any pertinent information.
  • Patients, or parent/legal guardian, are notified verbally regarding their appointment date, time, location, special instructions, and out-of-pocket expenses if applicable.
  • Follow up on referrals pending prior authorization/appointment is done at least weekly, documenting all efforts made in EHR.
  • Use of good time-management skills; contributing to increased productivity.
  • Actively participating in staff meetings and working toward accomplishing department goals and objectives; ability to work well with team members. Accomplishing related results as needed.
  • Statistics of all referrals processed are reported weekly to the Practice Manager.
  • Use multiple software systems for insurance verifications and referral processing purposes.
  • Demonstrates an understanding of organizational structure by utilization of appropriate channels of communication regarding all facets of departmental activities.
  • Use of computers, fax/copy machines for the exclusive uses of clinic business; keeping work areas clean and organized at all times.
  • Adhere to HIPAA confidential practices for patient information.
  • Adhering to all Sunset Health policies and procedures.
  • Performs other duties as assigned.

About the Company

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Sunset Health