Referral Specialist | Urology

The South Bend Clinic • South Bend, IN

13d • Onsite

About The Position

At The South Bend Clinic, you are supported to do your best work and make a meaningful impact every day. You will be part of a collaborative, physician-led team that works as one and puts patients at the center of everything we do. With a connected network of providers, care teams, and services across primary and specialty care, surgery centers, imaging, lab, and therapy, you are part of a system designed to deliver high-quality, coordinated care. Together, we create an environment where you can grow, contribute, and help improve the experience and outcomes for every patient we serve.

Requirements

• High school diploma or equivalent required.
• Prior computer experience and ability to navigate in systems required.
• Position requires constant and frequent sound judgment and response.
• Must have excellent phone communication skills; detailed focus and quality follow through; and ability to successfully multi-task.

Nice To Haves

• Previous procedure scheduling with strong knowledge of insurance requirements and prior medical office experience.

Responsibilities

• Obtains insurance pre-certification for all office procedures, medications, infusions, injections, surgery, diagnostic testing, DME, imaging, and medications.
• Performs timely documentation of status work in applicable electronic platform.
• Schedules patient procedures and/or tests with appropriate departments including involved parties.
• Obtains referrals as necessary.
• Ensures patients are informed of scheduled tests/procedures and insurance requirements prior to completion.
• Assists in benefit verification with patient insurance company so patient knows ahead of time what they will be financially responsible for, where applicable.
• Coordinates precertification and authorization processes with scheduling staff so appointments can be made in a timely manner.
• Obtains any and all pertinent clinical health information to process authorizations, referrals, and precertifications.
• Reinforces instructions and explanations of tests/procedures to patients per protocol.
• Documents all pre-certifications/authorizations in appropriate electronic platform.
• Verifies demographic information, including insurance when scheduling and/or obtaining pre-cert.
• Handles phone calls from patients regarding their insurance requirements for tests/procedures if applicable.
• Compiles necessary reports regarding pre-certification.
• Communicates with Business Office regarding verification of complex insurance and precertification requirements.
• Maintains good working relationships with all contacts.
• Utilizes up-to-date coding information.
• Takes initiative to seek out tasks and duties or to assist others as necessary.
• Exhibits computer systems knowledge and proficiency as necessary to perform job functions.
• Demonstrates the attitudes and behaviors of The South Bend Clinic Service Standards.
• Performs other duties as assigned when appropriate.
• Adheres to HIPAA guidelines set forth in Clinic policies and procedures.

Benefits

• Comprehensive medical, dental, and vision benefits that include healthcare navigation assistance.
• Access to a mental health benefit at no cost.
• Employer provided life and disability insurance.
• $5,250 Tuition Reimbursement per year.
• Immediate 401(k) match.
• 40 hours paid volunteer time off.
• A culture committed to community engagement and social impact.
• Up to 12 weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members once eligibility requirements are met.

What This Job Offers

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