Patient Referral Assistant

MyMichigan Health•Midland, MI

2d•Onsite

About The Position

This primary function of this position shall be to coordinate the timely completion, monitoring, and submittal of all incoming and outgoing third party payer referrals for primary care departments. The position will work closely with providers, insurers, and patients in obtaining, resolving, documenting, and communicating referral preauthorizations for specialist services and/or diagnostic testing procedures. The position will be a primary liaison with third party/managed care insurers to stay informed of the latest changes and developments with preauthorization referral procedures. Inclusive within this responsibility and equally important will be the maintenance of the incoming and outgoing referral databases on the Electronic Health Record Systems.

Requirements

Two to four years medical office experience
Excellent interpersonal/customer relations skills
Advanced medical terminology, ICD-9/ICD10, CPT coding experience within physician practice, knowledge of third payer rules, and medical record charting/documentation experience required.
Established written and verbal communication skills, good organization and prioritization skills, proficient computer user; experienced in Windows, Word Processing, and medical practice software, and able to work independently required.
Must be able to communicate verbally in person, on the phone and in writing.
MyMichigan Health is a technology driven organization and employees need to demonstrate competency in Microsoft® Windows.

Nice To Haves

Associate's degree preferred.
Experienced Medic Computer User and database application knowledge and skills preferred.
Knowledge of medical terminology as normally acquired through work experience in a medical office setting.

Responsibilities

Works with the providers, office staff & outside sources to complete third party referral authorization forms accurately and timely, transmitting some via mail, fax, telephone, or electronically on a frequent basis. Completes prior authorizations for testing and procedures, such as magnetic resonance imaging (MRI) and computerized axial tomography (CT) scans.
Enters and tracks incoming and outgoing referrals using Electronic Health Record systems; compiles monthly statistical reports on referral utilization for management reporting purposes on an occasional basis.
Coordinates investigation into and responds to disputed or incomplete referral requests on a weekly basis including authorizations and follow up on specialty appointments.