Purpose of the Job
This position is responsible for the coordination of Specialty Care patients, managing requests for incoming and outgoing referrals and prior authorizations. Acts as a liaison between health plans, patients and providers.
Job Functions
- Assures accurate processing of patient registration.
- Accurately schedules patient appointments according to clinic policy.
- Coordinates insurance referral actions and pre-certifications.
- Coordinates care with Ridgeview Patient Financial Services.
- Coordinates requests for release of medical information.
- Assists with coordination of completion of medical forms.
- Responsible for self-education to keep informed of changes within the care system guidelines.
- Serves as a liaison between patients, insurance company and provider.
- Coordinates with the Clinic Staffing Department coverage for current and upcoming shifts based on established guidelines and needs.
- Coordinates inpatient and outpatient services including imaging, lab, procedures, surgeries, etc.
- Ensures that all Specialty Care services have been captured and that documentation, coding and billing has been completed for each service.
- Collects and reports statistics as needed.
- Performs administrative support duties as needed.
- Performs other duties as assigned.
Employment Requirements
Minimum Education/Work Experience
- High School diploma or equivalent
- Strong customer service experience
- Attention to detail
- Two years’ healthcare experience
Knowledge/Skills/Abilities
- Ability to multi-task
- Ability to meet and maintain the necessary background checks as aligned with position functions
- Ability to communicate in the English language for effective written and verbal correspondence in order to complete job functions as mentioned above
- Ability to perform basic math functions and count money
- Ability to serve patients in a friendly and efficient manner
- Knowledge of basic computer functions and Microsoft Office applications
- Ability to respond appropriately to unpredictable situations and diverse patient populations
- Ability to work autonomously and as a team
- Capable of making independent decisions with the use of good critical thinking and problem-solving skills
- Knowledge of Medical Terminology
- Knowledge of ICD-10 coding
- Ability to prioritize workload according to medical necessity
- Ability to communicate in the English language for effective written and verbal correspondence in order to complete job functions as mentioned above
Preferred Qualifications
- 2+ years of experience in specialty
- Nursing Assistant, CMA or LPN
Compensation
Many factors are taken into consideration when determining compensation such as: the requirements of the position, experience, education, knowledge, and skills along with location and internal equity. Pay listed does not include any shift, weekend, or other differentials.
Benefits
Ridgeview strives to provide comprehensive and market competitive benefits to meet the needs of our employees and their families. Click here to view the benefits available.
