Referral Specialist (Sleep Medicine), full time, days

CURRENT HOLLAND HOSPITAL EMPLOYEES- Please apply through Find Jobs from your Workday employee account.

Under minimal supervision and with accuracy, performs duties to support department services. Performs insurance verification, registration and scheduling for a series of patients for numerous providers. Supports the department(s) clinical staff members, maintains medical record files, and performs charge/billing duties. Answers phones and directs callers to the appropriate person/department. Greets clients, and sorts and sends mail.

Employment Type: Full Time

Shift: Varied shifts Mon-Fri (7:30a-4p)

Weekly Scheduled Hours: 40
Requirements:

- High school diploma/GED or higher education

Referral Management

• Receives referrals from various referring physicians’ offices.
• Manages referrals originating through various IT systems.
• Verifies all information needed and enters referrals into appropriate systems
• Based on referral information and physician order, determines if the services require prior authorization.
• Tracks and records all referrals for management use in quality data to support accreditation requirements.
• Sends referrals back to referring offices once services are complete.

Insurance Verification

• Based on referral information, determines if the services require prior authorization.
• Collects additional information needed for pre-authorization via patients medical records and previous office visits.
• Contacts the insurance carriers to request authorization prior to services being rendered.
• Manages denials and appeals for all services and enters the appropriate authorization information into patient medical record / encounter.
• Works with Patient Financial Services to ensure completion of all prior-authorizations done for the department.

Scheduling and Registration

• Performs scheduling of patient appointments in all service scheduling apps.
• Manages schedules that are responsive to patient convenience while also optimizing efficiency in line with department goals.
• Verifies and updates all required patient demographic information.
• Pre-registers appropriate patients before arrival for their scheduled service.
• Continuously updates department tracking spreadsheets
• Sends weekly team e-mails updating referring offices on scheduling dates for their patients.

Office Operational Support

• Anticipates and provides support to all clinical staff.
• Assures that messages and mail are distributed in a timely and accurate manner.
• Provides clerical support to department leadership creating documents such as spreadsheets and forms.
• Takes minutes at meetings when asked.
• Completes projects as assigned by leadership.
• Multi-tasks between scheduling, registration, reception and other office duties.
• Identifies and maintains office/medical supplies and forms that need to be ordered.
• Greets clients in a professional manner and advises the appropriate staff member that the patient is waiting.
• Answers the phone promptly and courteously.
• Accurately takes and routes messages; assists callers to obtain satisfactory responses to their requests.
• Notifies staff of cancellations and filling open time slots.
• Makes reminder phone calls to the next days scheduled patients and provides appropriate pre-test instructions.
• Screens calls as appropriate and communicates with patients and provider offices in a professional manner.
• Coordinates with various medical groups to provide coverage for tests that require provider supervision.
• Maintains patient rights, confidentiality and ethical billing practices.

One year of experience in an office setting with similar duties required
High school diploma or GED equivalent required

For Sleep Center Employees: BLS Certification Required
General working knowledge of and ability to use office machines (including computer, fax, copy machine, and printer)
Excellent communication and interpersonal skills.
Ability to work independently as well as part of a team.
Microsoft Office skills.
Knowledge of medical terminology.
Ability to multitask.

Holland Hospital is an Equal Opportunity Employer, please see our EEO policy