Referral & Precert Spec

Covenant Health • Oak Ridge, TN

5d

About The Position

The Referral & Precert Specialist at Parkway Cardiology directs the daily operation of scheduling inpatient and outpatient procedures and services and obtains necessary referrals and pre-certifications. The role coordinates appointments among patients, facilities, and providers, maintains related documentation and tracking records, and collaborates with the care team to support patient care.

The position is full-time, 80 hours per pay period, on the day shift. Covenant Medical Group is the employed and managed medical practice organization of Covenant Health, serving East Tennessee through more than 300 physicians and advanced practice providers in 20 communities. It provides care across a broad range of specialties and is committed to coordinated, patient-centered care and access to providers close to home.

Requirements

• Medical terminology knowledge is required.
• Basic computer skills.
• Knowledge of ICD-9 and CPT coding.
• Education and/or prior work experience sufficient to demonstrate the knowledge, skills, and abilities needed for the job; this is typically equivalent to a high school diploma or GED.
• No licensure is required.

Nice To Haves

• Previous referral or pre-certification experience is preferred.
• A high school diploma or GED is preferred.

Responsibilities

• Schedule inpatient and outpatient tests, procedures, and appointments as directed by providers.
• Document each scheduled event in detail in the medical record.
• Complete forms required for referrals and pre-certifications accurately.
• Apply knowledge of requirements and guidelines mandated by insurance plans, hospitals, and outpatient facilities.
• Maintain accurate testing, referral, and appointment logs, including follow-up verification in the referral tracking database.
• Coordinate the date, time, and location of procedures or appointments with patients, facilities, and providers.
• Communicate appointments and any special instructions about scheduled procedures or appointments to patients.
• Report problems obtaining referrals, pre-certifications, or appointments ordered by providers.
• Perform other duties as assigned or requested.
• Attend required meetings and participate on committees as directed.
• Collaborate with patients, physicians, and other care team members as part of a team-based approach to patient care.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED