REFERRAL & PRECERT SPEC

Covenant Health • Oak Ridge, TN

2d

About The Position

Directs daily operation of scheduling for inpatient/outpatient procedures and services. Obtains any necessary referrals or pre-certifications.

Requirements

• None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED.
• Medical terminology knowledge a must.

Nice To Haves

• Preference may be given to individuals possessing a HS diploma or GED.
• 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.
• Knowledge of requirements and guidelines as mandated by insurance plans, hospitals and outpatient facilities.
• Maintains accurate testing, referral and appointment logs with follow-up verification in the referral tracking database.
• Knowledge of ICD-9 and CPT coding and basic computer skills.
• 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
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees