Referral Management Coordinator
About The Position
The Patient Engagement Access Center (PEAC) Referral Management Specialist is an important role for processing internal, incoming, and external referrals for all ambulatory services. In this role you will obtain prior authorizations, schedule patients, work inbound and outbound phone calls. You will also engage in conversations with patients on their responsibilities for copayment, prepayment, and any outstanding balance. WHO WE ARE Franciscan Health is a leading healthcare organization dedicated to providing exceptional patient care and promoting health and wellness in our community. Our mission is to ensure that every patient receives the highest quality of care through innovation, compassion, and excellence. With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers who provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Ensure current and standardized referral policies and workflows are followed and utilized on a regular basis. Prioritize referrals by their urgency and address them in a timely manner. Ensure complete demographic, insurance information, and appropriate/pertaining clinical information is sent to referred specialists. Contact insurance companies to ensure prior approval requirements are met. Present necessary medical information such as history, diagnosis, and prognosis to insurance companies if deemed necessary to prove the medical necessity of services. Review details and expectations about the referral with ordering providers and patients.
Requirements
- High School Diploma/GED
- 2 years Medical referrals, healthcare, and or prior authorization
Responsibilities
- Ensure current and standardized referral policies and workflows are followed and utilized on a regular basis.
- Prioritize referrals by their urgency and address them in a timely manner.
- Ensure complete demographic, insurance information, and appropriate/pertaining clinical information is sent to referred specialists.
- Contact insurance companies to ensure prior approval requirements are met.
- Present necessary medical information such as history, diagnosis, and prognosis to insurance companies if deemed necessary to prove the medical necessity of services.
- Review details and expectations about the referral with ordering providers and patients.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
