Referral and Scheduling Coordinator

CenterWell • The Villages, FL

2d • $39,000 - $49,400 • Onsite

About The Position

As a Referral and Scheduling Coordinator, you will be responsible for obtaining authorizations for medications, injections & contraceptive devices, scheduling appointments, taking payments, and calculating out of pocket costs based on insurance coverage. In addition, the Referral and Scheduling Coordinator serves as liaison between the organization and Specialty Pharmacies, to assist with coordinating specialty pharmacy medications. These services provide a smooth process for our patients by using “buy and bill” and/or specialty pharmacy.

Requirements

• Previous experience in authorization and knowledge of medical terminology
• Proficiency in Microsoft Office
• Excellent professional communication abilities, at all levels within the organization and with patients, at all times

Nice To Haves

• 1+ year of Insurance Verification and Authorization Retrieval
• Proficiency with Electronic Medical Records
• Bilingual in English and Spanish with the ability to read/write/speak fluently in both languages
• Knowledge of health care field and medical office protocols/procedures.
• Knowledge of billing practices and clinic policies and procedures.
• Knowledge of coding and clinic operating policies.
• Must be able to communicate clearly, accurately, and professionally with patients, internal and external customers, including insurance representatives.
• Must be able to consistently demonstrate a high level of organization.
• Must consistently demonstrate strong attention to details.

Responsibilities

• Contact insurance carriers to verify patient’s insurance eligibility, benefits, and requirements.
• Basic Knowledge of procedure codes (CPT) and diagnoses codes (ICD-10) to receive authorizations.
• Communicate with insurance companies, specialty pharmacies, vendors, and internal customers, to maximize efficiencies, and streamline process.
• Work with department leadership to develop policies, and workflows to support the auth ordering process.
• Request, track and obtain authorization from insurance carriers within time allotted for medial treatment. This includes processing denials and appeals.
• Review details and expectations about the authorization process with patients.
• Demonstrate and apply knowledge of medical terminology.
• Demonstrate high proficiency of general medical office procedures, including HIPAA regulations.
• Be the main point of contact for patients with regards to authorizations.
• Review clinical documentation to ensure it supports the insurance requirements for approval.
• Ensure that authorizations are addressed in a timely manner and the clinical teams are notified of delays, and when complete.
• Clearly document all communications and contacts with providers and personnel utilizing standardized documentation requirements, including proper format.
• Work with Purchasing department and care center leaders to assist with inventory management of purchased meds and consignment medication.
• Other duties as assigned.

Benefits

• medical
• dental
• vision
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed