Referral Specialist Mercy Health Physician Practice Salem (FT)

Company: Mercy Health
Location: Youngstown
Posted on: January 15, 2021

Job Description:

Thank you for considering a career at Mercy HealthJob DescriptionThe Referral Authorization Specialist is responsible for overseeing the daily processing of referrals in an efficient manner, facilitating patient information transfer and insurance authorization; . Utilizes effective phone and customer service skills; Enters complete and accurate information into appropriate computer system(s) - including but not limited to patient data in registration system, referring physician and patient's primary care provider.Mission/Core Values: It is expected that all of the duties and responsibilities of this position will be performed in a manner consistent with the Ministry's Standards of Behavior (CARE; Compassion: seeks to understand, listen and explain; Advocate: is the voice for the vulnerable; Respect: demonstrates the highest regard for and welcomes all people; Excellence: commits to the highest standard of quality care, joyful service, and teamwork) and in a manner that reflects the core values of Mercy Health which are: Excellence, Human Dignity, Justice, Compassion, Sacredness of Life and Service. All supervisors and above are expected to model the organizational mission and values through their daily actions, decision making and priority setting. All supervisors and above are expected to develop, implement and monitor short and long range plans to meet or surpass standards consistent with the overall strategic plan.ESSENTIAL FUNCTIONS (7-10 statements)% Time40%Obtains verification and pre-authorization on assigned diagnostic, surgical and ancillary services.20%Receives patient orders and referral faxed from referring physician's office. Communicates with the referring physician's office, other medical offices and/or patient to obtain any records (including radiology films) needed to help the physician make an informed medical decision about the patient's current medical condition. Attaches appropriate patient forms that need to be completed by the physician.Prioritizes the urgency of patient referrals to make sure patient is seen in a timely fashion.Communicates with the physician when the new patient cannot be seen within seven days or sooner if specified by the referring physician.20%Works collaboratively with all diagnostic and surgical service areas, physician offices and hospitals to ensure timeliness, accuracy and completeness when scheduling patient appointments, tests and procedures. Consistently and accurately document the date and time of appointment, test, scan or procedure in the patient's medical record. Provides thorough directions to the clinic, verify all paperwork has been received (or instruct patient to arrive early to complete such paperwork.Notify the appropriate area of the date and time of scheduled appointments, tests and procedures.15%Verifying eligibility, documenting physician direct referrals, obtaining pre-certification or authorizations of certain services as defined by the patient's health insurance plan.5%Performs related duties as required.100%Must Equal 100%.The above is intended to describe the general content and functions of this job. It is not to be construed as an exhaustive list of all duties or responsibilities. Employees may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation. The job description is subject to continual revisions as needed for patient care. Due to the services and care provided by this institution, personnel may be requested to serve in related capacities as determined by their qualifications in a different unit, department, and campus, in an effort to not disrupt patient care and continue to provide a safe environment to our patients. All employees are expected to follow Mercy Health policies and procedures, maintain high standards of safe work performance, and maintain good attendance and punctuality.MINIMUM QUALIFICATIONSMinimum Years and Type of Experience: --- Minimum of one year of experience as a referral coordinator preferred. --- A minimum of one year experience in a healthcare setting, healthcare insurance company, or managed care organization is requiredOther Knowledge, Skills and Abilities Required: * Knowledge of CPT procedure and ICD-10 coding required; Prior experience with an EMR system preferred; Strong analytical, organizational and time management skills; Ability to multi-task with little supervision;Ability to interact effectively and courteously with members, physicians, providers, payors, and co-workers.Other Knowledge, Skills and Abilities Preferred: knowledge of Microsoft Word and Excel; familiar with HIPAA guidelinesThis position requires the incumbent to demonstrate proficiency in clinical skills for patients in the following age categories (check all that differ from main job description):Mercy Health is an equal opportunity employer.We'll also reward your hard work with:* Comprehensive, affordable medical, dental and vision plans* Prescription drug coverage* Flexible spending accounts* Life insurance w/AD&D* An employer-matched 403(b) for those who qualify.* Paid time off* Educational Assistance* And much moreScheduled Weekly Hours:40Work Shift: Days Department: Salem Primary CareAll applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health - Youngstown, Ohio or Bon Secours - Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employer, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com

Keywords: Mercy Health, Youngstown , Referral Specialist Mercy Health Physician Practice Salem (FT), Healthcare , Youngstown, Ohio