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Req. No


Job Title

Health Plan Referral Specialist


CHRISTUS System Office


General Operations


CHRISTUS Corp Irving Offices 919 and 909 Buildings


919 Hidden Ridge
Irving, TX  75038
USView Other Locations



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This position is responsible for the coordination of Referral/Precertification Management information between Utilization Management and providers via telephone and/or faxed clinical information and for data entry of Utilization Management information as submitted by on-site Case Managers and/or providers.

  • Receive, process and complete data entry of demographic information for all referral and authorization requests from providers via fax or phone and as appropriate, forward to precertification nurse/care manager/case manager.
  • Begin on-line process utilizing skills of typing, medical terminology and ICD/CPT coding.
  • Request, document and forward out of network provider demographic information to PR Department and update case when appropriate
  • Using internal scripts, process auto-approve requests per department procedures
  • Begin on-line process of above, utilizing skills of typing, medical terminology, and ICD/CPT coding
  • Coordinate daily review activity for on-site case managers
  • Data entry of daily census, INN emergency room logs, and designated referrals/authorizations per management directive
  • Assist in maintaining files for department
  • Providing backup coverage for Clerical Support staff
  • Adhere to URAC standards
  • Communication, Collaboration and Coordination with all customers, internal and external
  • Collaborate with and maintain open communication with all other departments as appropriate and required to facilitate completion of tasks/goals
  • Follows the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability ACT (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI)
  • Attend monthly departmental meetings and/or interdepartmental meetings as appropriate
  • Ability to sit for long periods of time.
  • Ability to organize and prioritize work to meet deadlines.
  • Ability to work occasional long or irregular hours.
  • Good speaking ability, judgment, and initiative
  • Ability to work a flexible work schedule including evenings and weekends


  • High school diploma
  • Medical Terminology including procedure and diagnoses codes knowledge
  • Able to adapt in a fast-paced workplace
  • Referral/Authorization processes knowledge
  • Basic knowledge of computers
  • Excellent customer service skills
  • Works well with diverse groups of individuals
  • Minimum of two years in related working environment such as hospital, physician office, or managed care organization

Work Type: 

Full Time

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