Referral Specialist

Description

Location : UCHealth UCHlth Admin 2450 Peoria, US : CO : Aurora

Department : UCHlth Patient Line Referrals

FTE : Full Time, 1.0, 80.00 hours per pay period (2 weeks)

Shift : Days

Pay : $19.67 - $25.57 / hour. Pay is dependent on applicant's relevant experience

Summary :

Ensures compliance with managed care, commercial insurance, and public insurance requirements. Submits and tracks referrals. Provides efficient patient flow and service excellence.

Responsibilities :

Verifies eligibility and benefits; obtains authorizations for treatment or precertification of high cost drugs. Tracks referrals to ensure compliance with guidelines. Tracks formulary requirements.

Responds to third party payors, employers, internal staff, and physician questions. Maintains information on health plan guidelines. Provides training on plan requirements. Obtains Advance Beneficiary Notice (ABN) or Notice of Exclusions from Medicare Benefits (NEMB) if required. Ensures provider compliance with plan guidelines.

Ensures confidentiality of patient and institutional information. Provides routine information to customers and relays information appropriately.

Monitors patient needs and responds to inquiries. Prepares written reports.

Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action.

Requirements :

• High School diploma or GED. Preferred : Associate's degree.
• 6 months' experience in healthcare.

We improve lives. In big ways through learning, healing, and discovery. In small, personal ways through human connection. But in all ways, we improve lives.

UCHealth invests in its Workforce.

UCHealth offers a Three Year Incentive Bonus to recognize employee's contributions to our success in quality, patient experience, organizational growth, financial goals, and tenure with UCHealth. The bonus accumulates annually each October and is paid out in October following completion of three years' employment.

UCHealth offers their employees a competitive and comprehensive total rewards package (benefit eligibility is based off of FTE status) :

Loan Repayment :

UCHealth always welcomes talent. This position will be open for a minimum of three days and until a top applicant is identified.

UCHealth recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual's race, color, national origin, language, culture, ethnicity, age, religion, sex, disability, sexual orientation, gender, veteran status, socioeconomic status, or any other characteristic prohibited by federal, state, or local law. UCHealth does not discriminate against any qualified applicant with a disability as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.

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