Referral Specialist

Banner Health Mesa , AZ 85205

Posted 1 week ago

Health care is constantly changing, and at Banner Health, we are at the front of that change. We are leading health care to make the experience the best it can be.

We want to change the lives of those in our care and the people who choose to take on this challenge. If changing health care for the better sounds like something you want to be part of, we want to hear from you.

Seeking a Referral Specialist to join our board certified team of Surgeons specializing in Surgery and Trauma for our General Surgery team. Our group offers a more individualized role, working in a team environment, supporting staff and providers while working toward maintaining Banner's Mission.

Our Health Center is a very busy fast paced working environment where over a couple hundred patients visit us each day. We are looking for someone not only focused on patients as the number one goal but also a team player. A smile and greeting goes a long way in this position as you are a first impression.

Patient experience and the front desk interaction has targets and goals for us to meet. Having knowledge of insurance guidelines, understanding co-insurances, deductibles and copays, and understanding the difference between an authorization and a referral is very important in this role.

You will also have opportunities to expand your knowledge and skills through cross training, covering and supporting other specialties/locations and team leading through our Service Excellence Champion Program. You will also be able to interact with patients with consistent work schedules and a positive environment centered on caring for our patients and each other.

We are open Monday through Friday 8am to 5pm, no nights or weekends! Come join our Great East Valley team!

Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.

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Job Summary

This position is responsible for coordinating referral orders for a continuation of treatment, such as specialty services and diagnostic testing within a primary care practice. This position provides all pertinent clinical information needed for the payor authorization and the facility or specialist prior to the services being rendered. The position is responsible for tracking and managing all referrals with the intention and outcome to close any patient care gaps, along with providing documentation to promote team awareness.

Essential Functions

Schedules appointments for specialty physician services and diagnostic testing per provider request and communicates with the patient on a timely basis for all scheduling requirements

Acts as a liaison between patients, providers and staff members for patients referral and follow up needs. Provides prompt and professional service for the patients by assisting in educating patient/family and assisting patients with external resources when needed.

Provides all pertinent clinical information needed for the payor authorization, the facility or specialist prior to the services being rendered by verifying coverage, obtaining authorization and communicating with receiving facilities

Tracks and manages all referrals by monitoring outstanding referrals at 30/60/90 day intervals and following up with patients if appointments are not kept

Applies knowledge of medical terminology and maintains up to date knowledge of insurance environment. Utilizes internal and external resources to seek knowledge about regulations regarding various payor sources

Collaborates with outside referral sources and other community resources. Maintains an updated list of community resources and networks with colleagues to develop additional referral sources

Minimum Qualifications

High school diploma/GED or equivalent working knowledge.

Possesses 1 year of direct patient interaction/experience in a medical, insurance, or healthcare related industry. Knowledge of HIPAA regulations.

Strong customer service focus and willingness to problem solve. Effective verbal and written communication skills and the ability to manage competing priorities. Must be proficient with commonly used office software.

Preferred Qualifications

Previous knowledge of managed care concepts. Working knowledge of medical terminology and ICD-9 and CPT codes.

Additional related education and/or experience preferred.



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Referral Specialist

Banner Health