Referral and Scheduling Coordinator

CenterWell • The Villages, FL

1d • 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 a 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

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 benefits
• 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