Mount Carmel Health System

About Mount Carmel Health System

 

Job Category:

Healthcare

Country:

US

Approximate Salary:

Not Specified

Position Type:

Full Time

Referral Specialist Mount Carmel Medical Group East

Mount Carmel Health System - Columbus, Ohio

Posted: 11/15/2018

Department:

OH1PV_59200_000 PNO Patient Access

Expected Weekly Hours:

40

Shift:

Day Shift

Position Purpose:

At Mount Carmel, we work to continuously inspire one another. Here, all are welcome. It is this culture of humility and compassion that sets Mount Carmel apart. We see the big picture and do the right thing. That means a dedication to the well-being our both our colleagues and the patients they serve.

Job Description Details:

 Job Description:

The Referral Specialist coordinates, maintains, confirms and/or secures referrals, authorizations, or pre-certifications needed on physician/clinic services. Verifies the accuracy and completeness of admitting information on outpatient referrals and obtains authorizations when needed. Also maintains and keeps updated referral logs.

Responsibilities

  • Contacts insurance carriers after verifying information to secure benefit   coverage, policy limitations, pre-certification, etc. for customers.
  • Conducts follow-up calls as necessary to physician offices, patients, and third party payers to complete pre-certification process.
  • Contacts relevant internal staff to update status, coordinate resolution/correction of issues, sends records to insurance companies and determines whether a denied authorization should be appealed.
  • Educates internal and external customers regarding referral/prior authorization requirements, eligibility guidelines, documentation requirements, and insurance procedures.

Requirements/Qualifications

  • High School Diploma or equivalent
  • Basic computer skills required Obtain Nationally recognized Medical Assistant Certification or Registration within 90 days of hire
  • Must be able to work as a member of a team along with effective communication skills

Discovering opportunities, support and excellence – all while making a real difference in patients’ lives – begins at Mount Carmel. Find a new beginning and advance your career with us!

Mount Carmel and all its affiliates are proud to be equal opportunity employers. We do not discriminate on the basis of race, gender, religion, sexual orientation or physical ability.

Trinity Health's Commitment to Diversity and Inclusion

Trinity Health employs more than 120,000 colleagues at dozens of hospitals and hundreds of health centers in 21 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Trinity Health's dedication to diversity includes a unified workforce (through training and education, recruitment, retention and development), commitment and accountability, communication, community partnerships, and supplier diversity.

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