Referral Coordinator I-Days

General Summary

Performs a variety of support functions for each assigned practice including, but not limited to, scheduling, insurance verification, obtaining authorizations and referrals and record management.

Duties and Responsibilities

Essential Functions:

• Schedules patient appointments with specialty providers including correct processing of necessary referral forms and transfer of patient information.


• Ensures patient confidentiality.


• Manages the insurance referral process according to policy. Keeps staff current on changes.


• Reviews patient insurance to obtain authorizations for diagnostic testing, genetic labs, DME and medications.


• Provides insurance company with clinical information necessary to secure authorizations.


• Communicates with clinical team when authorization is unable to be obtained.


• Maintains referral record in electronic medical record.

Common Expectations:

• Maintains established policies and procedures, objectives, quality assessment and safety standards.


• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation


• Establishes and maintains files and records on an ongoing basis.


• Opens and routes incoming mail; distributes correspondence and other material to staff.

Required for All Jobs:

• Performs other related duties as identified.


• WellSpan Health has adopted and implemented a compliance program to support WellSpan's values and standards for professionalism, integrity, and ethics. Expected to support and meet the values and standards of the organization and the performance expectations of the job, the department, and the compliance program.


• WellSpan Health has adopted and implemented a privacy program to safeguard the patient information and the business and operational information of the organization. Expected to support and meet the values and standards of the organization to safeguard patient and business/operational information.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

Physical Demands:

• Standing - Occasionally


• Walking - Occasionally


• Sitting - Frequently


• Reaching - Rarely


• Talking - Frequently


• Hearing - Frequently


• Repetitive Motions - Occasionally


• Eye/Hand/Foot Coordination - Occasionally

Qualifications

Minimum Education:

• High School Diploma or GED Required

Work Experience:

• 1 year Medical insurance experience or experience obtaining authorizations and referrals from insurance companies. Required


• Medical front office experience. Preferred

Courses and Training:

• Medical terminology. within 180 days Required