Referral Coordinator - Home Health

PeaceHealth • Vancouver, WA

2d

About The Position

PeaceHealth is seeking a Referral Coordinator for its Home Health team. This full-time, 1.00 FTE, day-position helps ensure services approved by private payors are completed and requests additional visits as patients progress through their episodes of care. The role may also manage referrals, working with team members to support appropriate utilization and cost containment, and provides clerical assistance to staff.

The coordinator oversees referral data entry and forms, secures initial and additional treatment authorizations, and ensures payor documentation requirements are met and filed in patients’ medical records. The role manages correspondence with patients, physicians, specialists, insurance companies, billing staff, and third-party payors; documents relevant referral information; and helps ensure practitioners follow standardized, evidence-based guidelines.

The position is predominantly office-based and sedentary, with regular computer and office-equipment use. It may involve occasionally lifting, carrying, pushing, or pulling up to 10 pounds. Close visual acuity and the ability to communicate and exchange accurate information are required.

Requirements

• At least 3 years of experience working in insurance in a medical-related field, or other related experience.
• Demonstrated experience with insurance requirements for referrals and/or prior authorizations for therapies (PT, RT, OT, ST), surgeries, procedures, diagnostic testing, and infusions, including GYN procedures and testing.
• Proficiency with MS Office applications.
• Proficiency with Horizon Home Care.
• Ability to communicate and exchange accurate information.
• Close visual acuity for preparing and analyzing data and figures, transcribing, viewing a computer terminal, and extensive reading.

Nice To Haves

• Accredited-school education in business or two years of college.
• National Certified Medical Assistant credential.
• Licensed Practical Nurse credential in Washington.
• Registered Nurse credential.

Responsibilities

• Oversee data entry and completion of referral forms and notifications.
• Obtain insurance pre-authorization for patients 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 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 ensure coverage of patient care.
• Perform other duties as assigned.

Benefits

• Full medical, dental, and vision coverage.
• 403(b) retirement plan with employer base and matching contributions.
• Paid time off.
• Employer-paid life and disability insurance, with additional buy-up coverage options.
• Tuition and continuing education reimbursement.
• Wellness benefits.
• Expanded employee assistance program and mental health program.
• Competitive and comprehensive total rewards package supporting physical, emotional, financial, social, and spiritual wellbeing.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed