GENERAL SUMMARY:

The Referral Coordinator is responsible for receiving referral requests, obtaining physician approval, processing medical
records requests pertaining to referrals and processing the referral. Schedules appointments with the referral, when
necessary. Develops and maintains positive relationships with physician offices, patients and facilities while conveying
accurate benefit and payment details in regard to any and all future visits. Actively participates in outstanding customer
service and accepts responsibility in maintaining relationships that are equally respectful to all.

PRINCIPAL DUTIES AND JOB RESPONSIBILITIES:

• Demonstrates through AdventHealth's Service Standards of Own it, Love Me, Make it Easy and Keep Me Safe.
• Ensures pre-certification and verification of benefits has been obtained and clearly documented on all required exams
  prior to procedure.
• Makes outgoing calls or utilizes on-line recourses to obtain for pre-certification or any authorization required by the
  insurance carriers.
• Contacts patient or physician's office using HIPAA guidelines prior to schedule exam when additional information is
  required.
• Schedules hospital admissions, outpatient procedures/tests and notifies patient of appointment and referral number the
  same day it is obtained.
• Responds to all referrals within one to two business days.
• Notifies patients, physicians, and support staff with direct changes impacting the next day's schedule.
• Notified patients, physicians, and support staff with regard to appointment cancellations as a result of insurance denial,
  delay in obtaining insurance authorizations while effectively explaining the reason for the denial or delay.
• Performs other duties as assigned, to ensure the smooth operation of the office

Qualifications
KNOWLEDGE AND EXPERIENCE STRONGLY PREFERRED:

• Possesses a strong knowledge, understanding, and competency in the areas of insurance carrier plans and coverage
  benefits, procedures, CPT codes, HCPCS, and ICD-10 codes.
• Possesses a strong knowledge of required waivers or documents.
• Proficiency with Microsoft Office Suite (Outlook, Word, Excel, PowerPoint)
• Professional, oral, and written communication skills
• Problem solving and critical thinking skills
• Ability to work in a team setting, as well as, independently
• Ability to work well under pressure with deadlines - sense of urgency
• Ability to prioritize and manage simultaneous assignments with frequent interruptions while paying close attention to
  details
• Maintains effective working relationships with patients, team members and providers.

KNOWLEDGE AND EXPERIENCE PREFERRED:

• Medical terminology and office background
• Understanding of co-insurance, co-pays and deductibles and the ability to explain

EDUCATION AND EXPERIENCE REQUIRED:

• High School Grad or Equiv 0 years experience

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