Call & Referral Auth Coord

EvergreenHealth•Kirkland, WA

7d•$25 - $40

About The Position

Expedites the administrative requirements for patient referrals from primary care providers (PCPs) to specialists or specialty services, working directly with health plans. Makes decisions and authorizes risk planning referrals using department and organizational guidelines. The role involves daily interaction with patients, staff, healthcare providers, and insurance companies. All job functions are performed at EvergreenHealth’s scheduling call center.

Requirements

Associate’s degree or an equivalent combination of education and experience.
Three years of experience in a healthcare insurance or related medical office setting.
Working knowledge of ICD-9 and CPT codes.
Ability to be flexible and relate well with others in a professional and pleasant manner.
Knowledge of medical records confidentiality.
Excellent communication skills, with a high degree of tact and poise when dealing with patients, physicians, and hospital staff members.

Nice To Haves

Medical terminology, medical billing, and computer skills.
Working knowledge of insurance plans, Medicare, DSHS, Labor and Industries, and other third-party insurance.

Responsibilities

Processes patient referrals from PCPs to specialists, working directly with health plans and troubleshooting when necessary.
Coordinates information regarding managed care referrals for patients, providers, case managers, and other Utilization Management staff.
Assigns appropriate ICD-9 and CPT codes to patient referrals.
Communicates and disseminates key managed care contractual information and system processes to patients and staff.
Performs other duties as assigned.