Referral & Precert Spec

Covenant Health•Knoxville, TN

27d

About The Position

The Referral & Precert Specialist directs daily scheduling operations for inpatient and outpatient procedures and services and obtains necessary referrals or pre-certifications. The role coordinates procedures and appointments among patients, facilities, and providers, documents scheduled events, completes required forms, and maintains accurate tracking records. The specialist works with patients, physicians, and other care team members as part of a team-based approach to patient care. Covenant Medical Group is the employed and managed medical practice organization of Covenant Health. It provides comprehensive care across East Tennessee, with more than 300 physicians and advanced practice providers in 20 communities and specialties ranging from primary care and walk-in clinics to preventive medicine and advanced surgical and subspecialty services.

Requirements

Medical terminology knowledge is required.
Knowledge of ICD-9 and CPT coding and basic computer skills.
Education and/or prior work experience sufficient to demonstrate the knowledge, skill, and ability to perform the essential job tasks, typically equivalent to a high school diploma or GED; preference may be given to candidates with 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 the provider.
Document each scheduled event in detail in the medical record file.
Complete all 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, with follow-up verification in the referral tracking database.
Coordinate the date, time, and location of procedures or appointments with the patient, facility, and provider.
Communicate appointments and special instructions regarding scheduled procedures or appointments to patients.
Report problems obtaining referrals, pre-certifications, or appointments ordered by the provider.
Perform other duties as assigned or requested.
Attend meetings as required and participate on committees as directed.
Collaborate with patients, physicians, and other care team members as part of a team-based approach to overall patient care.