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Job description
Referral Representative - Pediatric Contact CenterJob Summary: Obtain referrals, pre-certifications and prior-authorizations via internet, faxing forms, and/or making calls to insurance companies. Schedule all procedures and the necessary pre-certification. Schedule all diagnostic tests and all necessary pre-certification. Follow up on all scheduled referral appointments, diagnostic testing, and procedures; confirming scheduled date/time, and patient notification. Document all referrals, procedures, and diagnostic tests in the appropriate log books and retain the information for review. Obtain Prior Authorizations for medications not included on patient formularies. Verify patient insurance 24hours prior to scheduled appointment time and troubleshoot / eliminate any patient eligibility issues identified. Act as back-up for the PSR position(s). Perform general office duties such as data entry, filing, etc. May be responsible for Invision/Flowcast registration and other functions as designated. Perform any other duties as directed.This position is involved in a team-based approach to care. Team members are trained to meet the highest level of function for their role as per the State of Tennessee/Georgia guidelines. Is trained and assigned (as per their role and responsibilities) to coordinate care for patients and is trained and assigned to support patients/families/caregivers in self-management, self-efficacy and behavior change. Is trained and assigned (as per their role and responsibilities) to manage the practices' patient population. Participates in the practice's quality improvement process and performance evaluation.Education Required: High school diploma and training for computer competency. Preferred: Medical terminology course desiredExperience Required: Must be proven to possess excellent communication skills and be able to interface appropriately with others of multiple ethnic and educational backgrounds. Highly organized, detail-oriented, self-starter with strong math skills who can function efficiently and professionally with all customers, both internal and external, in a demanding environment. Clerical experience and/or hospital experience a requirement. Always poised, courteous, pleasing personality and great telephone etiquette. Work requires knowledge of general business principles in a related healthcare or business field, or equivalent combination of education and experience. Previous experience with appointment scheduling, referrals, patient registration and data entry. Also will assist with other office functions such as chart preparation, as needed.
Worksite address
chattanooga, TN, 37402, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.