Referral Specialist Neurology

Banner Health•Mesa, AZ

3d•Hybrid

About The Position

Our Health Clinic is a very busy fast paced working environment where over a couple hundred patients visit us each day. We are looking for someone not only focused on patients as the number one goal but also a team player. This position is responsible for coordinating referral orders for a continuation of treatment, such as specialty services and diagnostic testing within a primary care practice. This position provides all pertinent clinical information needed for the payor authorization and the facility or specialist prior to the services being rendered. The position is responsible for tracking and managing all referrals with the intention and outcome to close any patient care gaps, along with providing documentation to promote team awareness.

Requirements

High school diploma/GED or equivalent working knowledge.
1 year of direct patient interaction/experience in a medical, insurance, or healthcare related industry.
Knowledge of HIPAA regulations.
Strong customer service focus and willingness to problem solve.
Effective verbal and written communication skills and the ability to manage competing priorities.
Proficient with commonly used office software.

Nice To Haves

Previous knowledge of managed care concepts.
Working knowledge of medical terminology and ICD-9 and CPT codes.
Additional related education and/or experience preferred.

Responsibilities

Manages incoming referrals for Neurology, Neurosurgical, and Neuroendovascular services across our Desert and Baywood locations.
Ensures all referral requirements are met prior to appointment.
Collects and organizes medical records.
Schedules appointments for specialty physician services and diagnostic testing per provider request and communicates with the patient on a timely basis for all scheduling requirements.
Acts as a liaison between patients, providers and staff members for patients’ referral and follow up needs.
Provides prompt and professional service for the patients by assisting in educating patient/family and assisting patients with external resources when needed.
Provides all pertinent clinical information needed for the payor authorization, the facility or specialist prior to the services being rendered by verifying coverage, obtaining authorization and communicating with receiving facilities.
Tracks and manages all referrals by monitoring outstanding referrals at 30/60/90 day intervals and following up with patients if appointments are not kept.
Applies knowledge of medical terminology and maintains up to date knowledge of insurance environment.
Utilizes internal and external resources to seek knowledge about regulations regarding various payor sources.
Collaborates with outside referral sources and other community resources.
Maintains an updated list of community resources and networks with colleagues to develop additional referral sources.
Frequent communications with patients, physicians, staff, and third party payers.
Works with and understand the concepts of managed health care and be able to prioritize tasks within established guidelines with moderate supervision.
Occasional travel between offices for training or coverage.