Job Attributes

Work Schedule/Shift

M-F

Job ID

5000388258806

Req. No

70028696

Job Title

Referral Coordinator

Region

CHRISTUS Central Louisiana/St. Frances Cabrini

Category

Healthcare

Division

Not Defined

Company

CHRISTUS Health

Travel

None

Facility

CHPG Stone Oak-365AB

Address

20642 Stone Oak Parkway
San Antonio, TX  78258
US

Type

Full Time

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Position Summary:

Arranges referral appointments for specialists utilizing managed care guidelines and practices. Maintains working knowledge of, and adheres to compliance with, Medicare, Medicaid, and managed care regulations.

Job Responsibilities:

1. Arranges referrals as indicated by the provider, utilizing proper insurance referral guidelines and CPT, ICD9 and HCPCS coding. May be required to send necessary lab and ancillary reports.

2. Verifies insurance information, current PCP, and medical necessity for the referral. Obtains authorization for release of medical records.

3. Obtains insurance pre-certification and authorization as required by the various insurance plans. Notifies the ordering provider of any conflict or delay in scheduling.

4. May schedule testing, make necessary appointments, document in the patient's chart and notify the patient of the appointment and necessary special instructions.

5. Pulls and retrieves files as required. Routes charts back to dictation area or file as indicated.

6. Answers telephones, routes messages and redirects as necessary.

7. Maintains referral log and verifies that patient completed appointment; verifies receipt of specialists consult notes and/or follows up with specialist if needed.

8. Follows the CHRISTUS Provider Network guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI).

9. Maintains strict confidentiality.

10. Uses oral and written communication skills to effectively convey ideas in a clear, positive manner that is consistent with the CHRISTUS Mission.

11. Maintains established CHRISTUS Provider Network policies, procedures, objectives, quality assurance, safety, environmental and infection control.

12. Implements job responsibilities in a manner that is consistent with the CHRISTUS Mission and Code of Ethics and supportive of CHRISTUS Provider Network's cultural diversity objectives.

13. Supports and adheres to CPN Service Guarantee.

14. Performs other related work as required.

Qualifications:

High school graduate or GED. Prefer one year work experience in a medical office setting. Knowledge of medical terminology and CPT, ICD9 and HCPCS coding necessary. Word processing and computer experience desirable. Ability to use various office equipment such as copiers, fax machines, and credit card machines. Excellent interpersonal skills and ability to communicate well. Must be organized with ability to perform multiple tasks in a busy environment. Knowledge of managed care contracts preferred
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