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Referral Coordinator - Wound & Enterostomal
PeaceHealth - Vancouver, WA
posted about 1 month ago
About the position
The Referral Coordinator - Wound & Enterostomal at PeaceHealth is responsible for overseeing the data entry and completion of referral forms and notifications. This role involves obtaining insurance pre-authorizations for patients, ensuring compliance with documentation requirements, and managing correspondence with patients, physicians, and insurance companies. The position is crucial for ensuring that practitioners follow standardized guidelines and that patient care is covered by insurance.
Responsibilities
- Oversee the data entry and completion of referral forms/notifications.
- Obtain insurance pre-authorization for patients and reauthorization of additional treatment.
- Ensure insurance carrier documentation requirements are met and referral support documentation is filed in the patient's medical record.
- Manage correspondence with patients, physicians, specialists, and insurance companies efficiently.
- Document pertinent information on referral forms and/or in medical records.
- Ensure practitioners follow standardized guidelines as recommended by evidence-based medicine.
- Communicate with billing staff and third-party payors to assure coverage of patient care.
- Perform other duties as assigned.
Requirements
- RN License or equivalent medical qualification.
- Minimum of 3 years experience working in insurance in a medical-related field or other related experience.
- Demonstrated experience in insurance requirements for referrals and/or prior authorizations to various therapies, surgeries, procedures, and diagnostic testing.
- Proficient with MS Office applications.
- Proficient with Horizon Home Care.
Nice-to-haves
- Accredited School Preferred: Business or two years college.
- Preferred: Medical Assistant, Licensed Practical Nurse, or Registered Nurse.
- National Certified Medical Assistant or Licensed Practical Nurse in Oregon, Alaska, or Washington.
Benefits
- Continuing education credits
- 403(b) matching
- Disability insurance
- Health insurance
- Dental insurance
- Paid time off
- Employee assistance program
- Vision insurance
