5 DAYS - 8 HOURS
Coordinator Referrals - Primary Pediatric
Children’s Hospital of San Antonio
CHRISTUS Childrens Hospital of San Antonio
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Coordinator Referrals - Primary Pediatric Job in San Antonio
This position is responsible for coordinating the entire referral process (obtaining order from physician, obtaining insurance authorization from the insurance company/payor, scheduling the appointment for the patient with a physician who accept the particular insurance, notifying the patient of the appointment, completing renewal authorizations with physician's office and payor) for a 35-physician practice. Research problem referral claims or requests for payment and corrects. Ensures physicians coding and Dx are appropriate for proper referral and coverage by insurance company. This position is also responsible for knowing various insurance plans and coverages for the patient to ensure proper payment. Responsible to teach nursing associates and physicians all changes within insurance plans for referral and authorization process. Must be up to date with all CPT and ICD-9 coding to process proper referral. Must have clinical background knowledge to appropriately support referral when communicating with insurance companies.
The Children’s Hospital of San Antonio, established in 1959, was the first children’s hospital in South-Central Texas. Located downtown, this 190-plus-bed hospital serves more than 70,000 children annually from San Antonio, South Texas and around the world. The hospital (in partnership with Baylor College of Medicine) is the only academic children’s hospital in San Antonio. Our highly specialized services meet the unique medical needs of children, from Pediatric and Neonatal Intensive Care to Children’s Emergency Services, the latest treatments for deformities of the spine including titanium rib implants and halo traction, a Heart Center, a specialized asthma program, a highly regarded Cancer and Blood Disorders Center, and growing maternal services to include consultation, delivery, and maternal fetal medicine.
- High School Diploma or equivalent is required.
- Minimum 3 years office experience in a healthcare setting required.
- Expert knowledge of managed care benefit plans with at least 1 year specializing in a referral-based clinic or physician’s office.
- Medical assistant certification from an approved technical school preferred.
- Must have excellent customer service skills, communicating with all customers (physicians, patients, insurance companies, staff etc.
- Bilingual (English and Spanish) is preferred.
- Must be able to deal with stress and handle difficult patients with tact and courtesy.
- Must be computer literate.
- Experience with billing and collections for physician office practice required.
- Must have a minimum score of 60 gross data sets per hour, 6000 keystrokes per hour and 2% or less error rate on a standard data entry test.
- Must understand importance of patient confidentiality and adhere to confidentiality expectations at all times.
- Must be able to work independently, with little or no direct supervision. Must be able to follow instructions accurately.
- Works in an office setting with adequate lighting and climate control.
- Work requires periods of time working with computer.
- Must successfully complete the pre-employment/post job offer health screening examination and the annual screening each year thereafter as an employee.
- Work may require flexible and/or extended hours, in order to meet customer needs.