Job Attributes

Work Schedule/Shift

Day

Job ID

5000445941706

Req. No

70034190

Job Title

***Referrals Coordinator- Pediatric Primary Care Clinic

Region

CHRISTUS Santa Rosa

Category

Administrative/Clerical

Division

Not Defined

Company

CHRISTUS Health

Travel

None

Facility

CHRISTUS Childrens Hospital-30200

Address

333 N Santa Rosa St
San Antonio, TX  78207
US

Type

Full Time

Apply Now ***Referrals Coordinator- Pediatric Primary Care Clinic 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 physicians office and payor) for a 35 physician practice. Researches 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

A. EDUCATION:

  • High School Diploma or equivalent is required.

B. EXPERIENCE:

  • 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.

C. LICENSURE/CERTIFICATION:

  • Medical assistant certification from an approved technical school preferred.
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