Referral Coordinator - OB GYN

PeaceHealth • Bellingham, WA

3d • Hybrid

About The Position

PeaceHealth is seeking a Referral Coordinator for its OB GYN services. The role assures that services approved by private payors have been completed and requests additional visits as patients progress through an episode of care. It may also involve managing referrals and working with team members to support appropriate utilization and cost containment. The position provides clerical support to staff.

This is a per diem/relief, 0.00 FTE day position. Work may be office/remote hybrid. Remote work requires the ability to work independently from a secure, distraction-free home environment with appropriate high-speed connectivity, and to report to the office within 60 minutes if required. Responsibilities may include travel between clinic sites and other locations.

The salary range is $25.62–$34.58. The hiring rate depends on factors including education, training, work experience, applicable collective bargaining agreement terms, and seniority.

Requirements

• At least 2 years of experience working in insurance in a medical-related field.
• Demonstrated experience with insurance requirements for referrals and/or prior authorizations for therapies (PT, RT, OT, ST), surgeries, procedures, diagnostic testing, infusions, and GYN procedures and testing.
• Proficiency with MS Office applications.
• Proficiency with Horizon Home Care.
• Ability to work independently in a remote environment, if applicable, from a secure, distraction-free location with appropriate high-speed connectivity and to report to the office within 60 minutes if required.
• Ability to communicate and exchange accurate information.
• Close visual acuity for activities such as preparing and analyzing data and figures, transcribing, viewing a computer terminal, and extensive reading.

Nice To Haves

• Education at an accredited school; business education or two years of college preferred.
• Medical Assistant, Licensed Practical Nurse, or Registered Nurse background preferred.
• National Certified Medical Assistant credential preferred.
• Licensed Practical Nurse – Washington credential preferred.
• Registered Nurse credential preferred.

Responsibilities

• Oversee data entry and completion of referral forms and notifications.
• Obtain insurance pre-authorization and reauthorization for additional treatment.
• Ensure insurance carrier documentation requirements, including Medicare requirements, are met and referral support documentation is filed in the patient's medical record.
• Manage correspondence efficiently with patients, physicians, specialists, and insurance companies.
• Document pertinent information on referral forms and/or in the medical record.
• Ensure practitioners follow standardized guidelines recommended by evidence-based medicine.
• Communicate with billing staff and third-party payors to assure coverage of patient care.
• Provide clerical support and assistance to staff.
• Travel to and from clinic sites and multiple locations when required.
• Perform other duties as assigned.

Benefits

• For positions below 0.5 FTE: 403(b) retirement plan for caregiver contributions, wellness benefits, discount program, expanded EAP, and mental health program.

What This Job Offers

• Career Level: Entry Level
• Education Level: Associate degree