Summary

Medical office position responsible for all referrals for the medical offices in the market

Responsibilities

• Process patient referrals for the practices in the market, Facilitates orders outside to outside facilities.
• Coordinate scheduling of office visits for the referred patient Assist patient with finding resources that accept the various insurances Obtains pre-authorization from payers.
• Calls insurance companies to get medications approved that may have been denied due to formulary changes.

Education: High school diploma/GED or equivalent working knowledge.

Certification: None

Experience: One year direct patient experience in a medical insurance or healthcare related industry.

Other Requirements: None

Performance Requirements:

Knowledge:

1. Knowledge of insurance verification process
2. Knowledge of specific Insurances such as Medicare and Tricare Prime
3. Knowledge of documentation required for physician appointments.
4. Knowledge of Electronic Health Systems
5. Knowledge of ICD-9, ICD - 10 and CPT codes
6. Knowledge of the policies and procedures of a clinic sufficient to provide effective patient care.