Description

Job Description

PeaceHealth is seeking a Referral Coordinator - OB GYN for a Per Diem/Relief, 0.00 FTE, Day position. The salary range for this job opening at PeaceHealth is $25.62 – $34.58. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.

Assure that the services that are approved by private payors have been done and that we request more visits for patients as we continue through the episode of care. May also be responsible for management of referrals; working closely with team members to ensure optimum utilization and cost containment. Provides clerical support and assistance to staff.

Essential Functions

• Oversees the data entry and completion of referral forms/notifications. Obtains insurance pre-authorization for patients and reauthorization of additional treatment. Ensures insurance carrier (including Medicare) documentation requirements are me and referral support documentation is filed in patient’s medical record.
• Efficiently manages correspondence with patients, physicians, specialists, insurance companies. Documents pertinent information on referral form and/or in medical record. Ensures practitioners are following standardized guidelines as recommended by evidenced based medicine.
• Communicates with billing staff and third-party payors to assure coverage of patient care.
• Positions may be office/remote hybrid requiring ability to work in an independent and remote environment; ability to work from home in a secure environment free of distractions with appropriate high-speed connectivity; ability to report to the office within 60 minutes if required.
• Responsibilities may include travel to and from clinic sites and multiple locations.
• Performs other duties as assigned.
  
  

Qualifications

Education

• Accredited School Preferred: Business or two years college and
• Preferred: Medical Assistant, Licensed Practical nurse, or Registered Nurse
  
  

Experience

• Minimum of 2 years Required: Experience working in insurance in a medical related field
  
  

Credentials

• Preferred: National Certified Medical Assistant or
• Preferred: Licensed Practical Nurse - Washington or
• Preferred: Registered Nurse
  
  

Skills

• Demonstrated experience in insurance requirements for referrals and /or prior authorizations to various therapies (PT, RT, OT, ST), surgeries, procedures, diagnostic testing, and infusions. GYN procedures, testing, etc (Required)
• Proficient with MS Office applications (Required)
• Proficient with Horizon Home Care (Required)
  
  

Working Conditions

Lifting

• Consistently operates computer and other office equipment.
• Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.
• Sedentary work.
  
  

Environmental Conditions

• Predominantly operates in an office environment.
  
  

Mental/Visual

• Ability to communicate and exchange accurate information.
• The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.
  
  

PeaceHealth is committed to the overall wellbeing of our caregivers. The benefits included in positions less than 0.5 FTE are 403b retirement plan for caregiver contributions; wellness benefits, discount program, and expanded EAP and mental health program.

See how PeaceHealth is committed to

For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.