POSITION SUMMARY: Primary function is coordination, processing and scheduling of medical referrals and prior authorizations for a variety of medical or surgical services/procedures for clinic patients, as requested electronically by clinic providers.
This requires clinical knowledge and understanding of CPT and ICD-9(10) codes to meet the requirements of third party payers and specialty clinics to ensure minimal delay in securing referral appointments or pre-authorizations. As an integral member of the health care Team, manages a high volume of referrals and pre authorizations for multiple Providers in multiple locations, collaborates with other Clinic Referral Specialists, Providers, MA's, Scheduler/Receptionists and other support staff in multiple clinic locations. This position requires the use of clinical and administrative judgment and initiative to determine best approach for both urgent and non-urgent patient care needs.
EDUCATIONAL REQUIREMENTS: High School diploma or equivalent required.
EXPERIENCE REQUIREMENTS: At least two (2) years of healthcare related experience to include knowledge of scheduling, referrals, and authorizations required.
Eastern Maine Healthcare Systems