Referral Specialist:
Centura Health

121554-en_US
Centura Health
Greenwood Village Colorado
Healthcare
Description

Centura Health Physician Group (CHPG) offers providers a true opportunity to live their calling to care while experiencing the support of a built-in comprehensive network, vast resources, professional growth, trusted leadership, generous benefits and an amazing quality of life with locations that span Colorado and into Western Kansas. CHPG is proud to connect providers and consumers through state-of-the-art technology, clinical resources and professional expertise to help people live healthier. Our coordinated services represent a full continuum of care – from preventive and early diagnoses to leading-edge treatment and life-saving critical care. CHPG’s ability to deliver better health care value is the direct result of combining the best clinical tools, shared resources and medical expertise with a patient-centered approach that emphasizes Centura Health’s mission and commitment to quality, compassion and service.



 



JOB DESCRIPTION/JOB POSTING ID: 121554



RECRUITER: Hailey Meseraull (haileymeseraull@centura.org)



CLINIC: Centura Health Connections - Greenwood Village, CO



DETAILS: Full-time



HOURS: Days



Occasional travel to other sites to meet the needs of the clinic may be required.


Position Summary



Obtains insurance authorizations for patient referrals from primary care physicians. Answers up to 30 inbound calls in a call center setting. Collect and verify insurance requirements to ensure payer requirements are met in a timely manner. Performs computer data entry and retrieval. Demonstrates strong interpersonal and customer service skills. Documentation appropriately on referrals and authorizations utilizing multiple computer systems.



Minimum Education Requirements




  • High School Diploma/GED

  • Associates degree preferred



Minimum Experience Requirements




  • 2 years' experience in healthcare setting or a combination of customer service and healthcare experience

  • Knowledge of medical terminology

  • Strong computer skills

  • Electronic medical record experience preferred

  • Experience obtaining insurance authorizations strongly preferred



License/Certifications




  • None Required



Position Duties (essential functions denoted with an * )




  • Obtain authorization with third party insurance companies for referrals to specialists and diagnostic testing.*

  • Obtain accurate information including all pertinent patient data to include but not limited to insurance verification, precertification numbers, birth date etc. *

  • Verify insurance coverage and authorization requirements for referral orders. *

  • Monitor work queues to ensure management of referrals in a timely manner. *

  • Provide specialists office with pertinent medical records, while maintaining confidentiality. *

  • Uses sound judgment when managing referrals to ensure patient safety.*

  • Manages the issues encountered when daily operational changes take place. Able to multi-task and work under pressure. *

  • Communicates in a timely fashion and functions as liaison with patients, physicians, physician office staff, insurance companies and other departments in a professional manner. *

  • Ensures phones are answered promptly in a pleasant and professional manner with the ability to answer/schedule caller’s needs or concerns quickly and efficiently. *

  • Effectively utilizes resources available to minimize errors. *

  • Adheres to department procedures and acceptable protocols. *

  • Reports any life safety issues, environmental concerns or process deviation to immediate supervisor.

  • Participates in quality improvement initiatives. *

  • Participates in professional and program development by attending department in-services, and meetings.

  • Assists with the education and training of staff. *

  • Demonstrates effective time management and is proactive in prioritizing workload and meeting productivity requirements. *

  • Adapts to rapidly changing technologies, policies, regulations, census and staffing through priority setting and flexibility. *

  • Adheres to strict work schedule guidelines during hours of operation.*



Physical Requirements



Sedentary Work - prolonged periods of sitting and exert/lift up to 10 lbs. force occasionally



 



 


 



Important notification to applicants as of Nov. 20, 2014: Effective Jan. 1, 2015, Centura Health will no longer hire tobacco users in Colorado and Kansas. The change to our policy does not apply to associates hired on or before Dec. 31, 2014. Centura Health is an Equal Opportunity Employer, M/F/D/V. 

Basic Qualifications
Requirement