Referral Coordinator

Conifer Health Solutions • Scottsdale, AZ

1d

About The Position

The Referral Coordinator is a non-exempt medical office position responsible for managing referrals for the medical offices in the market. The role processes referrals, coordinates scheduling and external orders, helps patients locate resources that accept their insurance, and obtains payer pre-authorizations. It also includes following Tenet policies and compliance requirements and maintaining accurate patient and provider information in the electronic system.

Requirements

• High school diploma, GED, or equivalent working knowledge.
• One year of direct patient experience in a medical insurance or healthcare-related industry.

Responsibilities

• Adhere to and support the mission, purpose, philosophy, objectives, policies, and procedures of Tenet Physician Resources.
• Adhere to the Tenet HIPAA Compliance Plan and Privacy Standards Confidentiality Agreement.
• Support the Tenet Corporate Compliance Program by understanding and following applicable responsibilities, laws, regulations, and policies, and reporting compliance issues or concerns promptly and appropriately.
• Process patient referrals for the practices in the market.
• Facilitate orders to outside facilities.
• Coordinate scheduling of office visits for referred patients.
• Help patients find resources that accept their insurance.
• Obtain pre-authorizations from payers.
• Call insurance companies to obtain approval for medications that may have been denied because of formulary changes.
• Check the system daily for patients who are not mapped correctly and update their charts.
• Set up referring providers and payers, and perform chart mergers in the electronic system.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED