JOB DUTIES

This position is responsible for processing referral requests for all providers practicing within the clinic module and ensuring that when needed, referral/authorization numbers are obtained for these services.

Essential Functions

• Attends Referral training class and various referral system training classes within 1st month of employment. Attends and actively listens and participates in the regularly scheduled Referral Coordinator meeting. Remains current on referral policies and procedures, payer requirements and Managed Care Matrix utilizing the various on-line resources.

• Processes referrals for services requested by Providers within established guidelines.

• Obtains authorizations for referrals and schedules appointments as appropriate and within required timeframes. Coordinates appointment date, time and location with patients.

• Processes requests for additional referrals/authorizations when requested by providers.

• Assures referrals are maintained within appropriate network or payer requirement.

• Communicates with all stakeholders, staff, providers, payers and patients as appropriate and per procedure.

• Documents required information into the appropriate systems.

• Provides a standard of excellence as it relates to customer service for patients, staff members, and other customers.

Temperament

Adhere to company policies and procedures, demonstrate the core values and Hospitality behaviors, resolve conflict through open, honest, professional communication, demonstrate positive and enthusiastic attitude, keep supervisor and leadership apprised of issues, and seek opportunities to recognize others.

SKILLS, QUALIFICATIONS, AND REQUIRED EXPERIENCE

Skills, Knowledge, Abilities

Insurance

• Knowledge of insurance plans and guidelines.

Insurance

• Ability to obtain authorizations and pre-certifications from insurance plans.

Customer Service

• Ability to provide dynamic customer service using various techniques including positive language, calming presence, attentiveness, clear communication, and patience.

Organization/Prioritization

• Ability to manage multiple priorities and meet deadlines.

Communication

• Ability to communicate effectively and courteously, both orally and in writing.

Organization/Prioritization

• Ability to organize and prioritize assignments to work independently as well as a collaborative team member.

Experience Requirements

Computer experience

preferred

2 years

Diagnosis and Procedural coding

preferred

2 years

Experience in the field or in a related area

required

2 years

Customer service

required

2 years

Third party payers (insurance carriers) using commonly used concepts, practices and procedures in the field

required

Education Requirements

High School Diploma or GED equivalent

required

Certificate

Medical Terminology

preferred

Job Type: Full-time

Pay: $15.00 - $19.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Ability to commute/relocate:

• Jacksonville, FL 32256: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Medical billing: 1 year (Preferred)
• Insurance verification: 2 years (Required)

Work Location: In person

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