REFERRAL & PRECERT SPEC

Covenant Health•Oak Ridge, TN

About The Position

The Referral & Precert Specialist directs the daily operation of scheduling inpatient and outpatient procedures and services and obtains necessary referrals or pre-certifications. The role coordinates scheduling details among patients, providers, and facilities, maintains documentation and tracking records, and supports coordinated, patient-centered care as part of the care team.

Requirements

Knowledge of medical terminology is required.
Knowledge of ICD-9 and CPT coding and basic computer skills.
Sufficient formal education and/or prior work experience to demonstrate the knowledge, skill, and ability needed to perform the essential tasks; this is typically equivalent to a high school diploma or GED. Preference may be given to candidates with a high school diploma or GED.

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, and document each scheduled event in detail in the medical record.
Complete all required referral and pre-certification forms 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 any special instructions to patients.
Report problems obtaining referrals, pre-certifications, or appointments as ordered by the provider.
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 overall patient care.