REFERRAL & PRECERT SPEC

Covenant Health • Oak Ridge, TN

15d • Onsite

About The Position

The Referral & Precert Specialist, Family Clinic of Oak Ridge, is a full-time position working 80 hours per pay period on the day shift. This role directs the daily operation of scheduling for inpatient/outpatient procedures and services, and obtains any necessary referrals or pre-certifications. Covenant Medical Group is the employed and managed medical practice organization of Covenant Health, providing comprehensive care across East Tennessee with over 300 physicians and advanced practice providers in 20 communities. They are committed to offering coordinated, patient-centered care across the health continuum.

Requirements

• Knowledge of requirements and guidelines as mandated by insurance plans, hospitals and outpatient facilities.
• Knowledge of ICD-9 and CPT coding and basic computer skills.
• Medical terminology knowledge a must.

Nice To Haves

• Previous referral/pre-certification experience preferred.

Responsibilities

• Schedules inpatient/outpatient tests, procedures and appointments as directed by provider. Documents each scheduled event in detail in the medical record file.
• Accurately completes all forms required for referrals and pre-certifications.
• Maintains accurate testing, referral and appointment logs with follow-up verification in the referral tracking database.
• Coordinates date, time and location of procedure/appointment with the patient, facility and provider.
• Communicates appointments as well as special instructions regarding scheduled procedure/appointment with the patient.
• Reports any problems obtaining referrals, pre-certifications or appointments as ordered by the provider.
• Perform other duties as assigned or requested.
• Attends meetings as required and participates on committees as directed.
• Collaborate with the patient, physician and other care team members as part of a team based approach to overall patient care.

What This Job Offers

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