Referral Specialist
Company: UCHealth
Location: Arvada
Posted on: October 11, 2021
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Job Description:
Summary:
Ensures compliance with managed care, commercial insurance, and
public insurance requirements. Submits and tracks referrals.
Provides efficient patient flow and service excellence.
Work Schedule: Full Time Days
Responsibilities:
Verifies eligibility and benefits; obtains authorizations for
treatment or precertification of high cost drugs. Tracks referrals
to ensure compliance with guidelines. Tracks formulary
requirements.
Responds to third party payors, employers, internal staff, and
physician questions. Maintains information on health plan
guidelines. Provides training on plan requirements. Obtains Advance
Beneficiary Notice (ABN) or Notice of Exclusions from Medicare
Benefits (NEMB) if required. Ensures provider compliance with plan
guidelines.
Ensures confidentiality of patient and institutional information.
Provides routine information to customers and relays information
appropriately.
Monitors patient needs and responds to inquiries. Prepares written
reports.
Within scope of job, requires critical thinking skills, decisive
judgement and the ability to work with minimal supervision. Must be
able to work in a fast-paced environment and take appropriate
action.
Requirements:
Minimum Required Education: High School diploma or GED. Preferred:
Associate's degree.
Required Licensure/Certification: None required.
Minimum Experience: 6 months' experience in healthcare.
The pay range for this position is: $16.07 - $24.10 / hour. Pay
is dependent on applicant's relevant experience.
An annual bonus may be paid to eligible employees based upon
organizational and individual performance.
UCHealth offers their employees a competitive and comprehensive
total rewards package. Some of the many benefits included in this
package are full medical, dental and vision coverage; retirement
plans; paid time off; employer-paid life and disability insurance
with additional buy-up coverage options; tuition and continuing
education reimbursement; and a full suite of voluntary benefits
such as identity theft protection and pet insurance. Our employees
and their family members have full access to our Employee
Assistance Program, which includes up to 5 free counseling visits
and work/life solutions, such as one free legal consultation. In
addition, other emotional counseling support is available depending
upon their need.
At UCHealth, we do things differently
We believe in something different: a focus on the individuality of
every person. In big ways and small, we exist to improve the
extraordinary lives of all those we serve. As Colorado's largest
and most innovative health care system, we as a team deliver on the
commitment to provide the best possible experience for our patients
and their families. We foster a true human connection and give
people the freedom to live extraordinary lives. A career at
UCHealth is more than a job, it's a passion.
Going beyond quality requires the perfect balance of talent,
integrity, drive and intellectual curiosity. We are looking for
individuals who recognize, like us, that the world of medicine is
ever-changing and are motivated to do what is right, not what is
easy. We support creativity and curiosity so that each of us can
find the extraordinary qualities within ourselves. At UCHealth,
we'll do everything in our power to make sure you grow and have a
meaningful career. There's no limits to your potential here.
Be Extraordinary. Join Us Today!
UCHealth recognizes and appreciates the rich array of talents and
perspectives that equal employment and diversity can offer our
institution. As an affirmative action/equal opportunity employer,
UCHealth is committed to making all employment decisions based on
valid requirements. No applicant shall be discriminated against in
any terms, conditions or privileges of employment or otherwise be
discriminated against because of the individual's race, creed,
color, religion, gender, national origin or ancestry, age, mental
or physical disability, sexual orientation, gender identity,
transgender status, genetic information or veteran status. UCHealth
does not discriminate against any "qualified applicant with a
disability" as defined under the Americans with Disabilities Act
and will make reasonable accommodations, when they do not impose an
undue hardship on the organization.
AF123
Keywords: UCHealth, Arvada , Referral Specialist, Other , Arvada, Colorado
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