Referral Specialist - OBGYN 5280, Highlands Ranch

University of Colorado • Aurora, CO

13d • Onsite

About The Position

The Referral Specialist is responsible for providing efficient, effective, quality customer service through a variety of duties, including, but not limited to, referral management, completing internal and external referral processes, and obtaining authorization from health plans and other Utilization Management (UM) entities for referrals. Also responsible for entering all referral and authorization information into EPIC and communicating outcomes to the patients, specialists, and other providers. Complies with established company policies and procedures, HIPAA Privacy Rules, and the University of Colorado School of Medicine Confidentiality Policy. Ensures clear and timely communication with patients, colleagues, and providers in a variety of clinical department(s). Assists in overall department work that may include overflow from other departments and/or locations.

Requirements

• High school diploma or equivalent.
• Two or more (2+) years of patient/client-facing experience.
• Must be able to work in-person.
• Must be able to travel to alternate locations as assigned.
• Strong organizational and personal skills; must have a strong work ethic.
• Strong communication skills, both written and verbal.
• Strong knowledge of medical terminology.
• Ability to maintain a positive attitude with clients, employees, and management.
• Ability to work quickly – individually and as part of a team.
• Ability to read, analyze, and interpret policies, documents, and regulations.
• Must be detail-oriented and maintain excellent organizational skills.
• Must be tech savvy (ability to understand, apply, and benefit from technology).
• Must be able to use basic office equipment.

Nice To Haves

• Associate’s degree.
• Previous experience in managed care referrals.
• Previous experience with ICD-10, CPT, and HCPCS coding.
• Two or more (2+) years of referral experience.
• EPIC, Kronos, and HealthStream experience.
• MS Office experience.
• Bilingual, Spanish-speaking.

Responsibilities

• Runs daily referral reports to create a work list and monitor referrals in place.
• Processes referrals according to departmental goals and accepted protocols, including referrals from current departments and other departments as directed.
• Verifies insurance eligibility and benefits from all resources, including eligibility lists or direct contact with insurance companies – e-verification or by telephone.
• Enters referral information into EPIC using correct coding procedures.
• Documents sufficient referral detail into EPIC so it is clear what was requested, what occurred, what was approved, and who was notified.
• Notifies patients of the referral process and authorization decisions; verifies patient understanding.
• Notifies referral provider of authorizations in a timely manner.

Benefits

• Medical: Multiple plan options
• Dental: Multiple plan options
• Additional Insurance: Disability, Life, Vision
• Retirement 401(a) Plan: Employer contributes 10% of your gross pay
• Paid Time Off: Accruals over the year
• Vacation Days: 22/year (maximum accrual 352 hours)
• Sick Days: 15/year (unlimited maximum accrual)
• Holiday Days: 15/year
• Tuition Benefit: Employees have access to this benefit on all CU campuses
• ECO Pass: Reduced-rate RTD Bus and light rail service

What This Job Offers

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