Centura Health Referral Specialist in Greenwood Village, Colorado
STATEMENT OF POLICY
A key focus of Centura's overall business strategy is talent development. Centura is committed to providing the tools and processes that will enable associates to plan their careers. The preferred practice is to post available positions on the Centura Health Career Website allowing visibility to job opportunities at Centura.
Associates are eligible to apply for an open position if they are:
Active in their current position for at least six months or have manager and HR approval to be released early;
Ratings meet expectations or higher on their PFD review;
No written warning or Performance Improvement Plan (PIP) within the last six months unless their manager receives approval from HR; and
Continuous sustained improvement is demonstrated.
Centura’s general practice is to post available positions on the Career Website for a minimum of three business days (HR reserves the right to close a posting based on the number of applications received within the three business days). The position may be posted internally and externally simultaneously. The organization reserves the right to post internally only before posting externally.
*JOB DESCRIPTION/JOB POSTING ID: 128273*
*CLINIC:* Health Connections
*DETAILS:* Full Time
*Occasional travel to other sites to meet the needs of the clinic may be required.*
Obtains insurance authorizations for patient referrals from primary care physicians. Answers up to 30 inbound calls in a call center setting. Collect and verify insurance requirements to ensure payer requirements are met in a timely manner. Performs computer data entry and retrieval. Demonstrates strong interpersonal and customer service skills. Documentation appropriately on referrals and authorizations utilizing multiple computer systems.
_Minimum Education Requirements_
High School Diploma/GED
Associates degree preferred
_Minimum Experience Requirements_
2 years' experience in healthcare setting or a combination of customer service and healthcare experience
Knowledge of medical terminology
Strong computer skills
Electronic medical record experience preferred
Experience obtaining insurance authorizations strongly preferred
- None Required
_Position Duties (essential functions denoted with an * )_
Obtain authorization with third party insurance companies for referrals to specialists and diagnostic testing.*
Obtain accurate information including all pertinent patient data to include but not limited to insurance verification, precertification numbers, birth date etc. *
Verify insurance coverage and authorization requirements for referral orders. *
Monitor work queues to ensure management of referrals in a timely manner. *
Provide specialists office with pertinent medical records, while maintaining confidentiality. *
Uses sound judgment when managing referrals to ensure patient safety.*
Manages the issues encountered when daily operational changes take place. Able to multi-task and work under pressure. *
Communicates in a timely fashion and functions as liaison with patients, physicians, physician office staff, insurance companies and other departments in a professional manner. *
Ensures phones are answered promptly in a pleasant and professional manner with the ability to answer/schedule caller’s needs or concerns quickly and efficiently. *
Effectively utilizes resources available to minimize errors. *
Adheres to department procedures and acceptable protocols. *
Reports any life safety issues, environmental concerns or process deviation to immediate supervisor.
Participates in quality improvement initiatives. *
Participates in professional and program development by attending department in-services, and meetings.
Assists with the education and training of staff. *
Demonstrates effective time management and is proactive in prioritizing workload and meeting productivity requirements. *
Adapts to rapidly changing technologies, policies, regulations, census and staffing through priority setting and flexibility. *
Adheres to strict work schedule guidelines during hours of operation.*
- Sedentary Work - prolonged periods of sitting and exert/lift up to 10 lbs. force occasionally)
Important notification to applicants as of Nov. 20, 2014: Effective Jan. 1, 2015, Centura Health will no longer hire tobacco users in Colorado and Kansas. The change to our policy does not apply to associates hired on or before Dec. 31, 2014. Centura Health is an Equal Opportunity Employer, M/F/D/V.