Work with Payors/Plans to process referrals/authorizations to completion according to policy and procedure. Assist Access Clinic providers/staff in identifying appropriate in-network providers for referred services. Assist patients with questions regarding referrals. Coordinate with other departments and facilities to ensure appointments are scheduled and patients have received the necessary information for their appointment(s). Work/address the referrals that remain open to determine if patient received the referred services. Contact Referred to provider to obtain consultation notes. Contact patients per established policy and procedure to ensure they receive referred services. Close referrals per established policy and procedure. Build and maintain relationships with Payor/Plan representatives and ACCESS clinic providers and staff; act as a resource to answer questions and solve problems Maintain accurate information regarding which external providers are contracted with each Payor/Plan. Monitor for delays in the prior authorization process and works with the Prior Authorization Department to ensure timely scheduling. Monitor referral phases to maintain compliance Monitor referral dashboards and work queues daily
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Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
251-500 employees