Referral Management Coordinator

Franciscan Alliance, Inc.

5d•$19 - $24•Remote

About The Position

The Referral Management Coordinator is responsible for processing internal, incoming, and external referrals for all ambulatory services. This position will obtain prior authorizations, schedule patients, and handle inbound and outbound phone calls. Referral Management Specialists are responsible for engaging in conversations with patients regarding their responsibilities for copayment, prepayment, and outstanding balances, and participating in the Point of Service (POS) collection process.

Requirements

High School Diploma/GED
2 years Medical referrals, healthcare, and/or prior authorization experience

Responsibilities

Processing internal, incoming, and external referrals for all ambulatory services.
Obtaining prior authorizations.
Scheduling patients.
Handling inbound and outbound phone calls.
Engaging in conversations with patients about their responsibilities for copayment, prepayment, and outstanding balances.
Participating in the POS collection process.
Ensuring current and standardized referral policies and workflows are followed and utilized on a regular basis.
Prioritizing referrals by their urgency and addressing them in a timely manner.
Ensuring complete demographic, insurance information, and appropriate/pertaining clinical information is sent to referred specialists.
Contacting insurance companies to ensure prior approval requirements are met.
Presenting necessary medical information such as history, diagnosis, and prognosis to insurance companies if deemed necessary to prove the medical necessity of services.
Reviewing details and expectations about the referral with ordering providers and patients.