Referrals and Precertification CoordinatorRetina Consultants of Texas • Houston, Texas, United States
Referrals and Precertification Coordinator
Retina Consultants of Texas
- Houston, Texas, United States
- Houston, Texas, United States
Über
Employee Paid Benefits such as Medical, Dental, and Vision, short-term disability, voluntary life insurance, accident, critical illness, hospital indemnity, pet insurance, HSA pre-taxed contributions, 401 (k) retirement savings contributions (both Roth and Traditional options) from starting date of hire. Employer Paid Benefits such as long-term disability, $25,000 basic life insurance policy, 3% 401(k) safe harbor contribution, HSA employer contributions, annual performance merit increases, certification opportunities, rewards & recognition platform, WellHub Starter Plan Gym Membership, paid time off and (8) paid holidays + (1) floating holiday annually.
Pay Rate is $19.00+ per hour and eligible for overtime. RCTX is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, age, national origin, disability, military service, veteran status, genetic information, or any other protected class under applicable law. Responsibilities
Obtains benefit verification and necessary authorizations (referrals, precertification) prior to patient arrival for all ambulatory visits, procedures, injections and radiology services. Uses Web IVR to generate authorizations and referrals (Availity, Optum, and any other approved web IVR for authorization processing). Obtain recertification for cases requiring extended treatment/coverage beyond the expiration of original approval. Creates appropriate referrals to attach to pending visits. Fax referral form to providers that do not require any records to be sent. Be able to process 75-80 referrals on a daily basis. Respond to In-house provider and support staff questions, requests and concerns regarding the status of patient referrals, care coordination and authorization status. Participate in Call Center Activities, triage and respond to incoming calls from patients, insurance companies, and physicians. May serve as single point of contact for an assigned group of prescribers. Educate patients, prescribers, and others regarding program requirements, and facilitate referrals. Maintain good housekeeping techniques, adhering to quality and production standards and comply with all applicable company, state, and federal safety and environmental programs and procedures. Identifies and communicates trends and/or potential issues to management team. Performs other related duties as assigned.
Qualifications
High School Diploma or GED required. Bachelor's Degree preferred. Minimum two to three years of experience in a healthcare environment in a referral, front desk or billing role. Healthcare experience with Managed Care Insurances, requesting Referrals, Prior Authorizations' for Insurances and verifying Insurance benefits preferred In-depth knowledge on insurance plan requirements for Medicaid and commercial plans preferred.
Sprachkenntnisse
- English
Hinweis für Nutzer
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