Referral Coordinator

Ardent Health Services Tulsa , OK 74120

Posted 3 weeks ago

Overview

Join our team as a day shift, full-time, Assesment & Referral Coordinator in Tulsa, OK.

Fulfilling your purpose begins here:

People First, Always. Here's how we take care of our people:

  • Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, 401k retirement plan with company match, employee assistance program and more

Your team is bigger than your department:

  • Utica Park Clinic, founded in 1982, is a multi-specialty medical group with more than 300 employed physicians and advanced practice providers representing over 25 specialties across 80 plus clinics in Oklahoma.

  • We believe healthcare is a team sport and every player has something to contribute. We show compassion, celebrate differences and treat one another with respect.

Responsibilities

  • Responsible for processing internal, incoming, and external referrals for Ambulatory services, procedures, and medications.

  • Obtain prior authorizations, schedule patients, work inbound and outbound phone calls, and communicate with patients via online chat.

  • Ensures complete demographic, insurance information, and appropriate/pertaining clinical information is sent to referred specialists.

  • Contacts insurance companies to ensure prior approval requirements are met.

  • Presents necessary medical information such as history, diagnosis, and prognosis to insurance companies if deemed necessary to prove the medical necessity of services.

  • Reviews details and expectations about the referral with ordering providers and patients.

  • Requests new referrals to be ordered when applicable.

  • Identifies and utilizes community resources; establishes relationships with servicing providers and personnel.

  • Receive requests for prior authorization through the electronic health record (EHR) and/or via phone or fax and ensure that they are properly and closely monitored.

  • Serves as point of contact for patients and specialists for any questions or concerns.

  • Process referrals and submit medical records to insurance carriers to expedite prior authorization processes.

  • Manage correspondence with insurance companies, physicians, specialists, and patients as needed, including documenting in the EHR as appropriate.

  • Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.

  • Review the accuracy and completeness of the information requested and ensure that all supporting documents are present.

Qualifications

Job Requirements:

  • High School Diploma or GED

Preferred Job Requirements:

  • Desired: Certified Medical Assistant

  • Previous medical office experience

  • Two or more years of experience with Electronic Health Record (EHR)

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