Referrals Representative

Eastern Maine Healthcare Systems Brewer , ME 04412

Posted 3 days ago

Job Details

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.



icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Customer Service Representative

Eastern Maine Healthcare Systems

Posted 3 days ago

VIEW JOBS 3/20/2019 12:00:00 AM 2019-06-18T00:00 Job Details Job Summary: Under the direction of the Supervisor of Cash Applications/Collection, the Customer Service Rep is responsible for answering the main telephone line into Patient Accounts. Patient inquiries are either handled on the spot or transferred to the appropriate person. The incumbent handles Attorney correspondence via email and phone calls. The incumbent handles all demographics via-email or phone calls. The incumbent performs duties and tasks in accordance with performance standards established for the job. The incumbent may have access to highly confidential patient, employee and/or Mercy proprietary information, and must handle & protect the information in accordance with hospital & system policies, HIPAA requirements and the highest level of ethical standards. The incumbent is responsible for reporting all security events, potential events, or other security risks to the organization. The incumbent is responsible for participation in and completion of all patient safety initiatives appropriate to the position, and conducts all job responsibilities according to the Mission and Values of Mercy Hospital. Requirements: A High School Diploma or GED is required. Post-secondary training in accounting, bookkeeping or related field is desired. A minimum of one (1) year experience in this or similar jobs is required. Additional experience with progressively more responsible tasks is desired. Experience in a healthcare and/or not for profit environment is preferred. Must be able to operate independently to complete all tasks with minimal supervision. Must have good interpersonal skills to interact with individuals in all levels of the hospital and the public. Must be accountable for accuracy and timeliness of work. Must be trustworthy and committed to confidentiality. Incumbent has access to confidential hospital, patient, and employee financial information. Eastern Maine Healthcare Systems Brewer ME

Referrals Representative

Eastern Maine Healthcare Systems