Overview Join our team as a day shift, full-time, Referral Program Coordinator in Tulsa, OK. Fulfilling your purpose begins here : People First, Always.
Here’s how we take care of our people : Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, k retirement plan with company match, employee assistance program and more Your team is bigger than your department : Utica Park Clinic, founded in , is a multi-specialty medical group with more than employed physicians and advanced practice providers representing over 25 specialties across 80 plus clinics in Oklahoma.
We believe healthcare is a team sport and every player has something to contribute. We show compassion, celebrate differences and treat one another with respect.
Responsibilities Responsible for processing internal, incoming, and external referrals for Ambulatory services, procedures, and medications.
Obtain prior authorizations, schedule patients, work inbound and outbound phone calls, and communicate with patients via online chat.
Ensures complete demographic, insurance information, and appropriate / pertaining clinical information is sent to referred specialists.
Contacts insurance companies to ensure prior approval requirements are met. Presents necessary medical information such as history, diagnosis, and prognosis to insurance companies if deemed necessary to prove the medical necessity of services.
Reviews details and expectations about the referral with ordering providers and patients. Requests new referrals to be ordered when applicable.
Identifies and utilizes community resources; establishes relationships with servicing providers and personnel. Receive requests for prior authorization through the electronic health record (EHR) and / or via phone or fax and ensure that they are properly and closely monitored.
Serves as point of contact for patients and specialists for any questions or concerns. Process referrals and submit medical records to insurance carriers to expedite prior authorization processes.
Manage correspondence with insurance companies, physicians, specialists, and patients as needed, including documenting in the EHR as appropriate.
Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed. Review the accuracy and completeness of the information requested and ensure that all supporting documents are present.
Qualifications Job Requirements : High School Diploma or GED
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