Referral Coordinator Front Office - TEMP Position - SSMG FC

Job Description

Job Description

SUMMARY

Front Office & Referral Coordinator frequently interacts with patients, doctors, and insurance companies, so this person must be able to multi-task with customer service needs while maintaining patient records confidentiality, managing multiple schedules and ensuring that patient information is complete and up to date for each appointment. In addition, this person must also be able to schedule outside patient referrals effectively for other needs including physical therapy, outside radiology services, and other clinical needs.

RESPONSIBILITIES AND DUTIES :

• Obtain and verify insurance eligibility for services provided and document complete information in system
• Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies
• Collect any clinical information such as lab values, diagnosis codes, etc.
• Determine patient’s financial responsibilities as stated by insurance
• Configure coordination of benefits information on every referral
• Ensure assignment of benefits are obtained and on file for Medicare claims
• Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures
• Identify and coordinate patient resources as it pertains to copay cards, third party assistance programs, and manufacturer assistance programs
• Handle inbound calls from patients, physician offices, and / or insurance companies
• Maintain medical charts and schedule appointments for staff.
• Perform routine medical data clerical tasks.
• Verify patient's health insurance coverage.
• Serves and protects the medical practice by adhering to professional standards, policies and procedures, federal, state, and local requirements.
• Answer multi-line phone system and take appointments or direct calls to the appropriate party
• Greet patients when they arrive at the office and provide them with any necessary paperwork or other information
• Collect co-pays and other fees required prior to the office visit or treatment
• Direct patients to the lab area for scheduled blood work and other testing
• Verify insurance coverage and assist the billing department with processing claims
• Assist patients with re-scheduling appointments and other scheduling issues
• Communicate test results to patients when directed by physicians or nursing professionals
• Inform patients of credit card declines and other billing issues
• Help coordinate patient referrals for outside services such as labs, radiology, physical therapy, and other clinical needs.
• Other duties as assigned.

EDUCATION & EXPERIENCE REQUIREMENTS :

SKILLS & ABILITIES REQUIREMENTS :