What are the responsibilities and job description for the Referral Coordinator position at Acute Wound Care?
Referral Coordinator
Acute Wound Care is a leader in specialty wound care and compression devices for the treatment of lymphatic and venous diseases. We help patients heal faster with successful outcomes and approved treatment options direct to the home. Acute Wound Care provides the highest quality compression devices and widest selection of custom sleeves manufactured in the USA. Our patient care team streamlines the order processing by working directly with referring clinicians, insurance carriers, and the patient to receive covered treatment.
Overview
The referral coordinator will be, as part of a team, responsible for accurately and efficiently initiating and following up on all prior authorization cases for medical equipment to health insurance carriers. for processing patient precertification’s, GAP exception cases, Single Case agreements, auth denials, and preservice appeals software. These are processed through multiple online platforms through calling the insurance carrier directly for specific cases. Responsible for daily entries into the patient EMR system to reflect new precertification cases, case updates, coordinating authorization to scheduling. Review of all approved cases to ensure they have correct HCPCS coding and units. Maintain a thorough understanding of the authorization process for different commercial carriers and managed care provider form requirements. Responsible for performing all job duties while adhering to HIPAA requirements.
Additional benefits:
Non-Exempt - Our total compensation package includes medical, dental benefits, retirement benefits 401k with employer match, paid time off, paid holidays. Benefits may be subject to generally applicable eligibility, waiting period, contributions, and other requirements and conditions.
Responsibilities
- Accurately set up precertification, GAP, and SCA requests
- Reconcile daily new requests for precertification’s
- Set up new appeal cases for preservice appeals
- Retrieve forms needed from patients or clinicals required by the carrier for appeal review.
- Ensure all data and phone interaction is recorded in the patient EMR system
- Communicate with scheduling all approved cases for patient to receive equipment.
- Working additional hours, when necessary, to meet month end goals
Qualifications
Education & Experience
Required:
- Minimum 1 year of healthcare related experience
Preferred:
- Accounting certificate, diploma or degree
- Previous experience working with Brightree.
Knowledge & Skills
- Outstanding attention to detail
- Strong alpha and numeric keyboard proficiency
- Ability to prioritize and complete tasks efficiently as a team player
- Knowledge of healthcare referral process
- Excellent verbal and written communications skills
- Proficiency working with Microsoft Office Suite
Competencies
- Detail Oriented
- Time Management
- Communication
- Process Management
- Priority Setting
- Peer Relationships
- Problem Solving
Job Type: Full-time
Pay: $20.00 - $22.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Experience:
- Insurance verification: 1 year (Preferred)
- Medical billing: 1 year (Preferred)
Work Location: In person
Salary : $20 - $22