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Posted: 31-Aug-24
Location: San Antonio, Texas
Salary: Open
Categories:
Internal Number: 192228
Summary:
This position is responsible for coordinating the entire referral process (obtaining order from physician, obtaining insurance authorization from the insurance company/payor, scheduling the appointment for the patient with a physician who accept the particular insurance, notifying the patient of the appointment, completing renewal authorizations with physicians office and payor) for a 35 physician practice. Researches problem referral claims or requests for payment and corrects. Ensures physicians coding and Dx are appropriate for proper referral and coverage by insurance company. This position is also responsible for knowing various insurance plans and coverages for the patient to ensure proper payment. Responsible to teach nursing associates and physicians all changes within insurance plans for referral and authorization process. Must be up to date with all CPT and ICD-9 coding to process proper referral. Must have clinical background knowledge to appropriately support referral when communicating with insurance companies.
The CHRISTUS Children?s Hospital, established in 1959, was the first children?s hospital in South-Central Texas. Located downtown, this 190-plus-bed hospital serves more than 70,000 children annually from San Antonio, South Texas and around the world. The hospital (in partnership with Baylor College of Medicine) is the only academic children?s hospital in San Antonio. Our highly specialized services meet the unique medical needs of children, from Pediatric and Neonatal Intensive Care to Children?s Emergency Services, the latest treatments for deformities of the spine including titanium rib implants and halo traction, a Heart Center, a specialized asthma program, a highly regarded Cancer and Blood Disorders Center, and growing maternal services to include consultation, delivery, and maternal fetal medicine.
Requirements:
- High School Diploma or equivalent is required.
- Minimum 3 years office experience in a healthcare setting required.
- Expert knowledge of managed care benefit plans with at least 1 year specializing in a referral-based clinic or physician?s office.
- Medical assistant certification from an approved technical school preferred.
Work Type:
Full Time
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