| Primary City/State: Phoenix, Arizona Department Name: Admin-Clinic Work Shift: Day Job Category: Administrative Services At Banner Health, we understand that talented health care professionals appreciate having options. We are proud to offer our more than 50,000 employees many career and lifestyle choices throughout our network of facilities. The people of Banner Health are focused on delivering excellent care to our patients. In return, we are committed to excellence in personal development for all our employees. Bring your experience and high energy as a Referral Specialist and join Banner's premier most northern health center. This center has an upscale Scottsdale design with includes covered parking, a gym next door, and amenities for staff and patients. Our Desert Ridge location is a diverse product facility, and has a diverse product line for patients from birth and beyond. Our Extended Hours Clinic has engaged staff that fosters an inclusive staffing model that allows staff to give input at meetings on how they move the facility forward. The leaders are very big on guiding the staff to operate the clinic successfully so they can grow and learn. Employees at this clinic have a sense of belonging, and the provider group is very engaged and communicate well with their clinic team. The leadership team offers a tremendous amount of feedback, and incentives to make work funs and engage everyone. Our customers and staff at Banner Health Center Desert Ridge say we are the practice with a "family feel". Shift is Monday-Friday 8a-5p At Banner Medical Group, you'll have the opportunity to perform a critical role in the community where you practice. Banner Medical Group provides both primary and specialty care throughout the communities in which Banner Health operates. We do this in a variety of settings - from smaller group practices like our Banner Health Clinics in Loveland, Colo. and Torrington, Wyo., to large multi-specialty Banner Health Centers in the metropolitan Phoenix area. We currently have more than 1,000 physicians and more than 3,500 total employees in our group and are seeking others to enhance our ability to deliver our nonprofit mission of providing excellent patient care. POSITION SUMMARY
This position is responsible for coordinating referral orders for a continuation of treatment, such as specialty services and diagnostic testing within a primary care practice. This position provides all pertinent clinical information needed for the payor authorization and the facility or specialist prior to the services being rendered. The position is responsible for tracking and managing all referrals with the intention and outcome to close any patient care gaps, along with providing documentation to promote team awareness.
CORE FUNCTIONS
1. Schedules appointments for specialty physician services and diagnostic testing per provider request and communicates with the patient on a timely basis for all scheduling requirements
2. Acts as a liaison between patients, providers and staff members for patients' referral and follow up needs. Provides prompt and professional service for the patients by assisting in educating patient/family and assisting patients with external resources when needed.
3. Provides all pertinent clinical information needed for the payor authorization, the facility or specialist prior to the services being rendered by verifying coverage, obtaining authorization and communicating with receiving facilities
4. Tracks and manages all referrals by monitoring outstanding referrals at 30/60/90 day intervals and following up with patients if appointments are not kept
5. Applies knowledge of medical terminology and maintains up to date knowledge of insurance environment. Utilizes internal and external resources to seek knowledge about regulations regarding various payor sources
6. Collaborates with outside referral sources and other community resources. Maintains an updated list of community resources and networks with colleagues to develop additional referral sources
7. This position has frequent communications with patients, physicians, staff, and third party payers. The position must work with and understand the concepts of managed health care and be able to prioritize tasks within established guidelines with moderate supervision
MINIMUM QUALIFICATIONS
High school diploma/GED or equivalent working knowledge.
Possesses 1 year of direct patient interaction/experience in a medical, insurance, or healthcare related industry. Knowledge of HIPAA regulations. Strong customer service focus and willingness to problem solve. Effective verbal and written communication skills and the ability to manage competing priorities. Must be proficient with commonly used office software.
PREFERRED QUALIFICATIONS
Previous knowledge of managed care concepts. Working knowledge of medical terminology and ICD-9 and CPT codes.
Additional related education and/or experience preferred. DATE APPROVED 11/09/2014 |
