Eligibility Referral Coordinator

Cardiac Solutions•Peoria, AZ

About The Position

The leading cardiology group in the West Valley is expanding and looking to add valuable and skilled team members to our comprehensive and long-standing Practice. Cardiac Solutions provides a personalized, team-oriented approach to patient care by promoting wellness through education, innovation, and technology. We offer intensive educational opportunities for patients through our disease management clinics and employ a multidisciplinary approach. All team members play a vital role in providing our patients with tailored care and support services. Our focus helps to prevent the progression of heart disease and minimize hospital admissions for our patients. Competitive wages Uniform/Scrub Allowance Monday - Friday for most positions 7 Company Paid Holidays Employee Medical coverage option as low as $25.00 per paycheck Dental & Vision Supplemental coverage options to include Life/AD&D, Short-Term, Long-Term, Critical Illness, Hospital, Accidental 401(k) retirement plan Paid Time Off Paid Sick Time Employee Assistance & Discount Programs Available to full-time, regular employees - Restrictions may apply POSITION SUMMARY: Responsible for obtaining referrals from primary care physicians (PCP) and authorizations from insurance companies for office visits, testing and hospital procedures when the plan requires authorizations. Verifies insurance and applies correct plan information in patient's accounts. Notifies patients of out of pocket responsibility for testing and procedures. This position is typically required to work mandatory overtime January through March of each calendar year. Please note that the overtime may be changed, modified or canceled at any time with or without notice.

Requirements

Knowledge of Microsoft Office products.
Knowledge of HIPAA regulations.
Knowledge of medical insurances.
Skill with working with multi-line telephone system.
Skill in working with outside facilities.
Ability to maintain confidentiality and professionalism.
Ability to work in a fast paced-environment and work well under pressure.
Minimum of one-year medical eligibility/referral/authorization experience.
Detail oriented.
Excellent verbal and written communication skills.
Excellent customer service skills.
Medical terminology.

Responsibilities

Verifies Primary and Secondary insurance plans.
Verifies and updates patient registration information in the practice management system.
Create new patient accounts for non-established patients.
Obtains benefit verification and necessary authorizations /referrals prior to patient arrival for all visits.
Creates appropriate referrals/cases to attach to pending visits.
Uses online, web-based verification systems and reviews real-time eligibility responses to ensure accuracy of insurance eligibility.
Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
Fax referral form to PCPs for office visits in timely fashion.
Manages both internal and external incoming calls to the department
Consistently seeks resources to stay informed on changing authorization requirements for testing and procedures.
Other duties and tasks assigned as appropriate or necessary.

Benefits

Competitive wages
Uniform/Scrub Allowance
Monday - Friday for most positions
7 Company Paid Holidays
Employee Medical coverage option as low as $25.00 per paycheck
Dental & Vision
Supplemental coverage options to include Life/AD&D, Short-Term, Long-Term, Critical Illness, Hospital, Accidental
401(k) retirement plan
Paid Time Off
Paid Sick Time
Employee Assistance & Discount Programs