This position provides both inpatient and outpatient referral services. The primary function is to verify patient benefits, process referrals using various insurance companies’ database, and coordinator outpatient services.
Minimal Qualifications, Experience & Skills
- High School diploma or equivalent (GED) from an accredited school/program
- Bilingual English/Spanish
- Efficient in use of Microsoft Word, Excel, internet and insurance database utilization.
- Knowledge of medical terminology and or experience in working in clinic setting preferred.
- Ability to multi-task and provide excellent customer service required.
- Electronic medical records experience preferred.
Responsibilities Include but are not limited to:
- Verify Insurance Eligibility
- Process referrals for inpatient and outpatient services
- Assist Care Coordinators with the coordination of outpatient and inpatient surgical procedures
- Collaborate with Care Coordinators to schedule appointments for patients needing emergency care or special procedures
- Process durable medical equipment (DME) orders, i.e., nebulizer machines, wheelchairs, walkers, etc.
- Arrange Home Health Care and Hospice services as ordered by provider
- Provide patient and provider education regarding insurance benefits and the referral process
- Communicate with patients via telephone, mail and or in person regarding referral, denials, and/or billing issues
- Acts as a liaison between providers, patients, IPAs, MCO, CCE’s, and insurance companies
- Other duties as assigned