Referral Coordinator

Þtails Department: Ascension Contact Center - Referral Management Schedule: 8:00am-6:00pm Monday-Friday Location:Remote Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition reimbursement Ways to give back to your community *Please note, benefits and benefits eligibility can vary by position, exclusions may apply for some roles (for example: PRN, Short-Term Option, etc.). Connect with your Talent Advisor today for additional specifics. Responsibilities Communicate with patients, participants and staff to accurately schedule patients for prescribed referral. Help patients navigate through their health care needs by assisting with referrals, insurance authorizations, scheduling appointments, and answering questions. Responsibilities: Within scope of job, requires superior critical thinking skills, decisive judgment and the ability to work with minimal supervision Confirms insurance coverage via payer portals and determines necessity for pre-authorization. Obtains authorization and processes referrals for services ordered by providers. Schedules appointments as appropriate and within required time and assuring referrals are maintained within appropriate network and/or payer requirement. Remains current on referral policies and procedures, payer requirements, managed care matrix, portals and determines financial responsibility for services to be provided. Communicates with patients, healthcare providers, and third-party service providers regarding insurance coverage and barriers to care. Documents detailed information in the patient medical record and any actions taken regarding authorization status, coverage issues, restrictions and appointment details. Notifies patients and providers of services requested that are not authorized by insurance. Gather necessary demographic, insurance and clinical information from patient and enters into appropriate database. Seek appropriate resources to resolve issues about the type, date or location of prescribed procedures. Schedule patient procedures in a manner that most efficiently utilizes the patient's time and clinical resources. Coordinate and communicate schedules. Assist with coordination of activities related to insurance pre-certification/authorization. Provide counseling to patient, participant or their representative regarding pre-service requirements and instructions. Requirements Education: High School diploma equivalency OR 1 year of applicable cumulative job specific experience required. Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable. Additional Preferences Do you have experience working with referrals? We are looking for experience working with referrals with physicians and patients. 2 years of experience full lifecycle with referrals for physicians and insurance companies Must have experience with obtaining referral approvals/prior authorization from medical insurance payors. Two years of experience working with medical insurance benefits and portals, pre-certification and prior authorizations, clinical documentation, and medical terminology Why Join Our Team Ascension associates are key to our commitment of transforming healthcare and providing care to all, especially those most in need. Join us and help us drive impact through reimagining how we can deliver a people-centered healthcare experience and creating the solutions to do it. Explore career opportunities across our ministry locations and within our corporate headquarters. Ascension is a leading non-profit, faith-based national health system made up of over 150,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states. Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you. Equal Employment Opportunity Employer Ascension will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws. For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster. Pay Non-Discrimination Notice Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants. This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information. E-Verify