Referral Coordinator - Medical Oncology

Trinity Health•Grand Rapids, MI

About The Position

Be Remarkable! Work in an organization that focuses on treating the whole person, physically, emotionally and spiritually. Position Summary: The Referral Coordinator maintains, confirms, coordinates and/or secures referrals, authorizations, and pre-certifications for referrals and diagnostic testing, verifies the accuracy and completeness demographics, insurance providers and payers on outgoing and incoming referrals, and follows standard workflow for referral management.

Requirements

High school graduate/ GED required.
Two years’ experience required in a medical office.
Extensive knowledge of the insurance market & prior authorization requirements.

Nice To Haves

Degree, Education and/or training as medical secretary, medical receptionist, medical assistant preferred.
Billing and coding knowledge and experience preferred.
Medical terminology and knowledge of medical office procedures preferred.

Responsibilities

Properly maintains and tracks referrals from beginning to end.
Answers, responds to and documents phone calls, requests and questions from patients, physicians, ancillary services or specialty offices in a timely manner.
Assembles information concerning patient’s clinical background and referral needs.
Obtains necessary authorization for referrals and diagnostic testing in timely fashion with proper documentation.
Works denied claims for missing prior authorization or referral within the EMR system.
Confirms payer is in-network with specialist. If not, contact patient to discuss and make alternate arrangements as necessary per payer guidelines in communication with the care team.
Maintains and updates reference materials as they pertain to insurance carriers.
Other duties as assigned.