Precert/Referral Coordinator - Gastro - Full-Time

Job Summary

Provides a variety of patient and customer service related activities within the Physician Practice, particularly liaison with other physician's office and insurance companies. These activities include but are not limited to greeting patients and the public, answering and screening telephone calls, scheduling patient appointments, preparing the medical record, and serving as the liaison between the patient and medical support staff. Performs general office duties such as data entry, filing, balancing charges and collections at the end of each day. Provides patients with insurance pre-certification and schedules specialist referrals. Performs any other duties as directed.

This position is involved in a team-based approach to care. Team members are trained to meet the highest level of function for their role as per the State of Tennessee/Georgia guidelines. Is trained and assigned (as per their role and responsibilities) to coordinate care for patients and is trained and assigned to support patients/families/caregivers in self-management, self-efficacy and behavior change. Is trained and assigned (as per their role and responsibilities) to manage the practices' patient population. Participates in the practice's quality improvement process and performance evaluation.

Education:

Required:

High School diploma or equivalent.

Preferred:

Experience:

Required

Previous experience in a health/medical setting. Previous experience in understanding insurance plans and referrals, pre-authorizations, appointment scheduling, data entry and deposits. Computer experience with MS Windows, Outlook and medical software applications.

Preferred:

Minimum 2 years in a physician’s practice. Knowledge of medical billing including CPT and ICD 9 & 10 coding.

Position Requirement(s): License/Certification/Registration

Required:

Preferred:

Department Position Summary:

Provides a variety of patient and customer service related activities within the Physician Practice structure and as the liaison between external departments, physician's office and insurance companies. These activities include but are not limited to greeting internal and external customers, entering phone messages into the EMR system, scheduling appointments in FlowCast, performing general office duties, accurate data entry, filing, obtaining pre-certification and pre-authorizations for procedures and medications, scheduling referrals for patients via the referral proxy and fax system, and all other duties as assigned.