Precertification and Referral Specialist

Job Title: Precertification and Referral Specialist

Location: Woodruff Road Office

Reports To: Woodruff Road Physician Practice Director

General Summary of Duties: Schedules patients for advanced imaging procedures and specialty referrals from primary care provider. Advises patients of procedural and financial requirements depending upon scheduling facility and procedure to be performed. Coordinates and schedules appointments for procedures at the clinic, ambulatory outpatient imaging facility or hospital.

Supervisory Responsibilities: None

Major Responsibilities/Tasks:

• Coordinate and schedule advanced imaging procedures and follow-up appointments as designated by physicians according to established policies and procedures.
• Interact with patients, physicians, and other staff within the clinic and outside facilities providing accurate, timely and responsive information.
• Coordinate processes and timing as required to meet physician and facility requirements.
• Schedule diagnostic therapy and other treatments as requested.
• Obtain authorization from patient’s insurance company.
• Provide patient with generic preparatory information sheets and advise patients of financial requirements.
• Submit patient clinical and financial information to facility assuring appropriate medical records release, if needed.
• Answer and screen telephone calls in a courteous manner, and record messages for physician and other personnel.
• Obtain accurate information from patients and ensure all registration forms are complete.
• File records in appropriate sections of patient electronic charts and keep patient charts in proper order.
• Maintain files and patient records in a confidential manner.
• Perform other related duties as directed or assigned.

EDUCATION: High school diploma or GED.

EXPERIENCE: Minimum of two years of scheduling/pre-certification experience in a medical office, including experience with insurance policies and procedures and preauthorization.

Performance Requirements:
Knowledge:

• Knowledge of clinic policies and procedures.
• Knowledge of medical terminology and insurance practices.
• Knowledge of computer programs and applications.
• Knowledge of grammar, spelling, and punctuation to type, review reports, documentation, and correspondence.
• Knowledge of CPT and ICD-9 coding.

Knowledge and Skills:

• Skill in operating office equipment and able to learn/use other computer programs including electronic medical records system, Microsoft® Office 365, and Internet.
• Skill in handling incoming phone calls and triaging appropriately.
• Skill in written and verbal communication and Ability to establish and maintain effective working relationships with patients, employees, and the public.
• Skill in gathering, interpreting, and reporting insurance information.
• Skill in trouble-shooting insurance issues and resolving appropriately.
• Ability to work effectively as a team member with physicians and other staff.
• Ability to sort and file materials correctly by alphabetic or numeric systems.
• Ability to interpret and understand insurance benefits and reimbursement.
• Ability to flexibly respond to changing demands.
• Ability to organize and prioritize tasks effectively.
• Ability to communicate clearly.
• Ability to work with little supervision.

Work Environment: Work performed in office environment. Involves frequent contact with staff and patients. May require working under stressful conditions.

Physical Demands/Working Conditions:

• Requires prolonged standing or sitting. Requires frequent bending, stooping, or stretching. May require lifting, up to 50 pounds.
• Requires eye-hand coordination and manual dexterity.
• Requires the use of office equipment, such as: computers, electronic medical record software, patient monitoring equipment, and photocopiers.
• Requires normal visual acuity and the absence of color blindness.

This position is considered an hourly, full time, non-exempt status.

Job Type: Full-time

Pay: From $16.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $16