We are recruiting for a motivated Specialist Senior, Patient Referral Management-3 to join our team!
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Department
Appointment CenterJob Summary
Under general supervision, Patient Referral Management agent serves customers by determining requirements, answering inquiries, resolving problems, fulfilling requests, and maintaining records. Responsible for patient referral processing, insurance authorizations, scheduling, liaises between insurance company and customer. Complete various administrative tasks to support our patients by sending referral documentation to our different departments that are internal and External. Work within a small team to organize, manage, and deliver referral documents on behalf of our patients. Possess excellent customer service and communication skills, cross-trained in all aspects of Call Center responsibilities and provides support to Management team.
Essential Functions:
Responsible for processing/transcribing internal and external referrals via different modalities that include faxes and EHR. (20%)
Resolves customer problems by clarifying issues, researching and exploring answers and alternative solutions; implementing solutions; escalating unresolved problems. (5%)
Maintain communications and collaborate with patient, provider, payer representative and staff. (5%)
Gathers patient information by collecting demographic information from a variety of sources; enter and update patient information into Electronic Medical Records; maintains call center databases by entering information. (5%)
Schedule of internal appointments according to preset scheduling guidelines. (5%)
Maintains patient confidence by keeping patient records information confidential; delivers quality results by following organizational standards. (5%)
Serves and protects the community by adhering to professional standards, organizational policies and procedures, federal state, and local requirements, and accreditation standards. (5%)
Maintains continuity of work operations by documenting and communicating actions, irregularities and continuing needs; keeps equipment operation by following established procedures and reporting malfunctions. (5%)
Enhances organization reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments. (5%)
Familiarity with health insurance policies and procedures. (5%)
Understand medical diagnosis to discuss with health insurance companies and to determine why a patient must be referred. (5%)
Understands standardized scheduling, rescheduling, and cancellation guidelines. Schedules to appropriate provider according to patient request, provider direction, and availability. (5%)
Update job knowledge by participating in educational opportunities. (5%)
Proficient in verification and updating demographic, financial, guarantor, insurance and patient information for new and existing patients within the practice management/electronic health record and various Denver Health computer applications. (5%)
Determines requirements by working with internal and external customers; answers inquiries by clarifying desired information. (5%)
Other Duties as assigned. (5%)
Education:
High School Diploma or GED Required
Associate's Degree Two years of College or Associate's Degree Preferred
Work Experience:
4-6 years Three to five years in a hospital/medical office setting preferred or relevant experience in a customer service business with the ability to relate to a diverse patient population. Required and
4-6 years Familiar with a variety of healthcare concepts, practices, and procedures. Required
Licenses:
Knowledge, Skills and Abilities:
Ability to prioritize and perform a multitude of duties with great attention to detail and a high level of accuracy in a fast paced environment relying on extensive experience and judgment to plan and accomplish goals.
Knowledge of Commercial Insurance referral and authorization process is preferred.
Knowledge of medical terminology and benefits.
Excellent customer focus/service, people skills, listening, verbal and written communication, problem solving and multitasking skills.
Relationship building, instructing, teaching, process/change execution, flexibility, and reporting.
Able to type 40wpm and possess intermediate knowledge of PC applications (NT, Windows), healthcare applications and phone systems.
Shift
Work Type
Regular
Salary
$20.43 - $28.60 / hr
Benefits
Outstanding benefits including up to 27 paid days off per year, immediate retirement plan employer contribution up to 9.5%, and generous medical plans
Free RTD EcoPass (public transportation)
On-site employee fitness center and wellness classes
Childcare discount programs & exclusive perks on large brands, travel, and more
Tuition reimbursement & assistance
Education & development opportunities including career pathways and coaching
Professional clinical advancement program & shared governance
Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program
National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer
Our Values
Respect
Belonging
Accountability
Transparency
All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made.
Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver?s 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, a Public Health Institute, an HMO and The Denver Health Foundation.
As Colorado?s primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year.
Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.
Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community.
Applicants will be considered until the position is filled.
Take your career to the next level at Denver Health, where we offer a robust benefits package and endless opportunities for growth. Denver Health is a nationally-ranked, locally-trusted, premier healthcare institution located in the heart of Denver, Colorado.Twenty-five percent of all Denver residents, or approximately 150,000 individuals, receive their health care here. We are known as an integrated health care system that encompasses multidisciplinary academic specialties, a community health system, a level I adult trauma center, pediatric emergency and urgent care center home to Denver Public Health and many of the nation's leaders in medicine.Denver Health is an Equal Opportunity Employer At Denver Health we pride ourselves on our commitment to diversity. Equal opportunity is a fundamental principle of Denver Health. As an equal opportunity employer, Denver Health is committed to recruit, hire, promote and administer all human resource actions in a non-discriminatory manner. Denver Health is committed to providing equal opportunities in all business practices and to all persons regardless of age, race, color, national origin, genetic information, religion, sex, pregnancy, disab...ility, sexual orientation, gender identity, gender expression, marital status or veteran status (collectively “protected status”). Denver Health strives to maintain a work environment that is free from unlawful harassment and discrimination and will not tolerate any such conduct by employees or directed at employees within the scope of their employment. Read the full Human Resources Employee Principles and Practices policy.