What are the responsibilities and job description for the Reference Based Pricing Coordinator (REMOTE) position at Lucent Health Solutions LLC?
Reference Based Pricing Coordinator
(REMOTE)
SUMMARY
Lucent Health has an opportunity for Reference Based Pricing Coordinator to support the RBP Operations Team Lead working collectively with the Lucent Health Care Management (LHCM) Utilization Review (UR), Case Management (CM) and Concierge Teams to provide prepricing of medical procedures to TPA client members and provide coverage when the RBP Operations Team Lead is on vacation or other scheduled time out of the office..
PURPOSE
RBP Coordinators are responsible for providing Reference Based Prepricing services on behalf of the TPA Client’s Health Care Plans to promote transparency of costs for anticipated care.
ESSENTIAL DUTIES AND RESPONSIBILITIES
RBP Coordinators shall be responsible for all phases of RBP operations, but shall be primarily focused on:
- Receiving and reviewing preauthorization’s for RBP plan members for prepricing.
- Coordinating with the UR Team to obtain any missing information regarding preauthorization.
- Accessing the prepricing portal and entering the preauthorization information to create a pre-claim.
- Creating the pre-estimate pricing letter from the pre-claim.
- Contacting facilities for appropriate fax numbers or to confirm billing form type.
- Faxing pre-estimate pricing letters with the preauthorization to facilities via the portal fax system.
- Receiving and reviewing all revised preauthorization’s with changes i.e., date of service, facility name/NPI, procedure codes etc. and updating information in pre-pricing portal.
- Sending all revised pre-estimate pricing letters to facilities via the portal fax system
- Maintaining the RBP worksheet with data entry of all received preauthorization’s and update with all actions taken.
RBP Coordinators shall also be responsible for Identifying missed referrals to RBP and communicating this information to the appropriate UR team for referral completion.
Skills
- Excellent communication, written, telephonic and personal skills
- Ability to multitask
- Attention to detail
- Completion of all responsibilities in a timely manner
- Independent thinking
- Strong Organization Skills
Qualifications
- Proficient in computer technology including Microsoft Office Word, Excel and Teams
- Data Entry with excellent accuracy
- Medical Terminology preferred
- Team skills
- Strong communication skills
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Equal Employment Opportunity Policy Statement
Lucent is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.
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