POSITION DESCRIPTION:
This position is responsible for all aspects of the referral process, including authorizations and follow-up.
ESSENTIAL JOB FUNCTIONS:
Contacts insurance companies via appropriate methods and obtains authorizations if applicable for specific plans. Educates patients and staff with pertinent referral and insurance information. Obtains urgent authorizations same day and next day, if needed. Assists patients in scheduling appointments with specialist and help resolve referral issues. Generates referral information for physicians, patients and health plans. Acts as a liaison among providers, patients and health plan administrators. Responsible for reviewing and submitting clinical information to health plan case managers for special referral pre-certification and out-of-plan or out-of-network referrals; monitors authorizations or denials and follows up, as necessary....