Referral Coordinator Lead

Job Description

Description

PeaceHealth is seeking a Referral Coordinator Lead for a Full Time, 1.00 FTE, Day position. The general salary range for this job opening at PeaceHealth is $23.44 – $34.78. The actual hiring rate is dependent upon several factors, including but not limited to, the job/position responsibilities, location, terms of the applicable collective bargaining agreement, education, training, work experience, seniority, work performance, etc.

Assure that the services that are approved by private payors have been done and that we request more visits for patients as we continue through the episode of care. May also be responsible for management of referrals; working closely with team members to ensure optimum utilization and cost containment. Provides clerical support and assistance to staff. Responsible for coordinating the day-to-day functions for assigned area. Assists with ensuring that departmental goals are achieved, timelines met and service excellence provided in all aspects of work. Subject matter expert.

DETAILS OF THE POSITION:

• Assigns work; plans and manages priorities, provides technical assistance, oversees staff schedules, monitors quality of work, monitors team projects, mentors staff, provides constructive feedback, oversees staff training, ensures quality improvement, provides leadership feedback on staff performance, and assists with goal setting for the team.
• Oversees the data entry and completion of referral forms/notifications. Obtains insurance pre-authorization for patients and reauthorization of additional treatment. Ensures insurance carrier (including Medicare) documentation requirements are met and referral support documentation is filed in patient’s medical record.
• Efficiently manages correspondence with patients, physicians, specialists, insurance companies. Documents pertinent information on referral form and/or in medical record. Ensures practitioners are following standardized guidelines as recommended by evidenced based medicine
• Communicates with billing staff and third party payors to assure coverage of patient care.

• Accredited School Business or two years college preferred
• Minimum of 3 years Required: Experience working in insurance in a medical related field, or other related experience
  
• National Certified Medical Assistant, Oregon Licensed Practical Nurse, or Registered Nurse preferred
• Demonstrated experience in insurance requirements for referrals and /or prior authorizations to various therapies (PT, RT, OT, ST), surgeries, procedures, diagnostic testing, ophthalmic exams, GYN procedures, testing, etc. (Required)
• Proficient with MS Office applications, required
• Proficient with Horizon Home Care, required

PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.

To learn more please contact Maureen:  [email protected]

See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.

For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.

PeaceHealth requires a completed Primary Vaccine Series (e.g., 2 dose monovalent Pfizer, Moderna or Novavax series or 1 dose J&J vaccine series) or be Up to Date (receiving the most recent Pfizer/Moderna bivalent vaccine/booster) for COVID-19 vaccination prior to their start date. PeaceHealth has a medical and religious exemption request process for those that are unable to receive the COVID-19 primary vaccine series due to medical/religious reasons. For caregivers that will be working in Oregon there is a personal vaccine exemption form that may be requested.