Job Family: Administrative Support
Type: Full time
Date Posted: Dec 04, 2023
Reference: JR96357
Description
Clinic Referral Coordinator
Location: Washington, DC
Hours: 8 am - 5 pm EST
CareMore is a proud member of the Elevance Health family of brands, offering clinical programs and primary care options for seniors. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery. The Clinic Referral Coordinator is responsible for the completion and submission of appropriate forms for patients whose health plan requires authorizations and referrals for services and/or treatment at a facility other than that of the referring physician.
How you will make an impact:
Educates and assists patients with the authorization and referral process, referrals for specialty care or treatment, and additional clinical testing.
Enters authorization into the portal scans and ensures accurate completion of authorization and referral forms.
Submits completed prior authorization forms to the appropriate Utilization Management department.
Maintains logbook of all authorizations and referrals submitted.
Assists patients in the scheduling of appointments with the specialist or facility to which the patient has been referred and scheduling transportation, if necessary.
Tracking of patients’ data with complete demographics, contact numbers and insurance information.
Reaching patients before scheduling an appointment, after scheduling is done and for reminding of appointments for referrals.
Communication with referral sources to ensure patient information/ registration is complete.
Ensure referrals are addressed in timely manner according to the level of urgency.
Serve as focal person to communicate with multiple internal and external parties on coordination for scheduling referral and getting results.
Put together patients’ information clinical background and complete necessary insurance forms.
Communicates with insurances for ensuring prior authorization approval.
Eligibility verification and updating patients charts of patients in care center daily schedules.
Making confirmation calls for patients in care center daily schedules.
Assist patients in check-in and checkout at front desk.
Record keeping and reporting.
Minimum Requirements:
Requires a HS diploma and a minimum of 6 months of experience processing referrals/authorizations and/or working knowledge of the referral/authorization process; or any combination of education and experience which would provide an equivalent background.
Bi-lingual (English/Spanish) required in most offices.
Preferred Skills, Capabilities and Experiences:
Previous experience in a customer service role.
Previous experience in a telephonic role.
Previous experience in a medical setting is preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.comfor assistance.