Coordinator Referrals - Specialty General Surgery

CHRISTUS Health • Mount Pleasant, TX

11d

About The Position

This position coordinates the entire referral process for a 35-physician practice. Duties include obtaining physician orders and insurance authorization, scheduling patients with physicians who accept their insurance, notifying patients of appointments, and completing renewal authorizations with physician offices and payors. The coordinator researches and corrects problem referral claims or payment requests, ensures physician coding and diagnoses are appropriate for referrals and insurance coverage, and understands insurance plans and coverage to support proper payment. The role also teaches nursing associates and physicians about changes to insurance plans and referral and authorization processes. Up-to-date CPT and ICD-9 coding knowledge and a clinical background are needed to support referral work and communication with insurance companies.

Requirements

• High school diploma or equivalent required.
• Up-to-date knowledge of CPT and ICD-9 coding.
• Clinical background knowledge to support referral work and communication with insurance companies.

Nice To Haves

• 1–3 years of experience preferred.

Responsibilities

• Coordinate the referral process, including obtaining physician orders and insurance authorizations, scheduling appointments with physicians who accept the patient's insurance, notifying patients, and completing renewal authorizations with physician offices and payors.
• Research and correct problem referral claims or requests for payment.
• Ensure physician coding and diagnoses are appropriate for referrals and insurance coverage.
• Understand insurance plans and patient coverage to support proper payment.
• Teach nursing associates and physicians about changes to insurance plans and referral and authorization processes.
• Maintain current CPT and ICD-9 coding knowledge to process referrals appropriately.
• Use clinical background knowledge to support referrals when communicating with insurance companies.
• Meet expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED