Referral Specialist (Imaging #2090 FT) |
| Location: | Eugene, OR |
| Salary Range: | $11.88 - $16.63/Hourly |
| Exempt/Non-Exempt: | Non-Exempt |
| Benefits: | 40 Hrs/Wk; Benefited |
| Employment Type: | Full Time |
| Department: | Imaging |
| Description: | Assists patients by coordinating the referral process at the clinic, properly entering appropriate information into the computer, coordinating insurance, and ensuring accuracy of patient information. |
| Duties: | (This list may not include all of the duties assigned)
1. Takes pertinent information from patients, specialists’ offices and insurance companies regarding referral requests, problems or questions.
2. Assists in coordination of the referral process at the clinic.
3. Processes appropriate referrals on SARS systems and Regence HMO systems.
4. Processes prior authorizations of SARS and enters on PA/Daily Census log.
5. Generates denial letters to patients, providers and insurance companies.
6. Notifies providers and facilities of approved prior authorizations.
7. Processes Oregon Medical Group employee referrals.
8. Supports patient accounts staff regarding referral/EOB issues.
9. Reviews all incoming referrals prospectively and retrospectively.
10. Assists patients and specialty office staff with referral information by phone or mail.
11. Enters referrals into the computer and review referrals for accuracy prior to physician review.
12. Maintains strictest confidentiality.
13. Ongoing Customer Service Training.
14. Performs other duties as assigned.
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| Qualifications: | Skill in operating a computer, calculator and photocopy machine. Knowledge of coding policies and procedures and insurance reimbursement practices. Ability to examine documents for accuracy and completeness. Ability to maintain confidentiality of sensitive information. Ability to clearly communicate with patients, physicians and staff.
Education: Equivalent of a high school diploma.
Completion of a course in medical records technology preferred.
Experience: 1-2 years of experience with medical coding practices and medical office experience preferred. Background in managed care and previous insurance benefit verification a plus.
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