REFERRAL & PRECERT SPEC

Covenant Health • Harriman, TN

9d

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 appointments among patients, facilities, and providers, communicates appointment details and special instructions, and maintains documentation and tracking records. It collaborates with patients, physicians, and other care team members as part of a team-based approach to patient care. The role is with Roane Surgical Group, part of Covenant Medical Group, the employed and managed medical practice organization of Covenant Health. Covenant Medical Group provides care across East Tennessee and has more than 300 physicians and advanced practice providers in 20 communities.

Requirements

• Knowledge of requirements and guidelines mandated by insurance plans, hospitals, and outpatient facilities.
• Knowledge of ICD-9 and CPT coding.
• Basic computer skills.
• Medical terminology knowledge.
• Any combination of formal education and/or prior work experience sufficient to demonstrate the knowledge, skill, and ability needed to perform the essential job tasks; typically equivalent to a high school diploma or GED. Preference may be given to individuals with a high school diploma or GED.

Nice To Haves

• Previous referral or pre-certification experience preferred.
• High school diploma or GED preferred.

Responsibilities

• Schedule inpatient and outpatient tests, procedures, and appointments as directed by the provider, and document each scheduled event in detail in the medical record.
• Complete all forms required for referrals and pre-certifications accurately.
• 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 patients, facilities, and providers.
• Communicate appointments and special instructions regarding scheduled procedures or appointments to patients.
• Report problems obtaining referrals, pre-certifications, or appointments as 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.

What This Job Offers

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