Eligibility and Referral Coordinator - Newport Beach, United States - PhyNet Dermatology LLC

PhyNet Dermatology LLC

Verified Company

Newport Beach, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

We are seeking a highly organized and detail-oriented Eligibility and Referral Coordinator to join our dynamic dermatology office team.

The Eligibility and Referral Coordinator plays a crucial role in ensuring seamless coordination of patient referrals, promoting effective communication between healthcare providers, and enhancing the overall patient experience.

ESSENTIAL FUNCTIONS:
To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation.

Referral Processing**:

Receive and review referral requests from both internal and external sources.
Verify referral information for accuracy and completeness.
Ensure all necessary documentation is included in the referral request

Communication:

Collaborate with referring healthcare providers to obtain additional information when needed.
Communicate with patients to provide information about the referral process and schedule appointments with specialists.
Maintain open lines of communication between our dermatology office and referring healthcare professionals

Documentation and Record Keeping:

Maintain accurate and uptodate records of all referral activities.
Input referral information into the electronic health record (EHR) system.
Generate reports on referral status and outcomes for review by management

Insurance Verification:

Verify insurance coverage for referred services and communicate relevant information to patients.
Coordinate with the billing and insurance teams to address any preauthorization requirements.
Navigate local IPA/HMO portals such as Optum, Hoag Physician Partners, Availity, and others efficiently

Appointment Scheduling:

Schedule appointments for patients with specialists or for additional diagnostic tests as needed.
Ensure that appointments align with both patient and specialist availability

Follow-Up:

Track and manage the status of pending referrals to ensure timely completion.
Follow up with patients to confirm receipt of specialist appointments and address any concerns

Collaboration:

Collaborate with other administrative staff, healthcare providers, and specialists to optimize the referral process.
Participate in regular meetings to discuss and improve referral workflows.

KNOWLEDGE, SKILLS, & ABILITIES:

High school diploma or equivalent; additional education or certification in healthcare administration is a plus.
Previous experience in insurance eligibility verification and prior authorization within a medical setting, preferably in dermatology.
Familiarity with medical terminology, insurance processes, and electronic health record systems.
Excellent communication skills, both written and verbal.
Strong organizational skills and attention to detail.
Ability to work independently and collaboratively in a fastpaced healthcare environment.
Familiarity and comfort with navigating local IPA/HMO portals, including Optum, Hoag Physician Partners, Availity, etc.

PHYSICAL AND MENTAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job responsibilities.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit for extended periods of time; use hands to finger, handle or fell objects, tools, or controls; reach with hands and arms; climb stairs; balance, stoop, kneel, bend, crouch or crawl; talk or hear; taste or smell.

The employee must occasionally lift, push, pull and/or move up to 25 pounds. Repetitive motion of upper body required for extended use of computer.

Required specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

WORK ENVIRONMENT AND TRAVEL REQUIREMENTS:

Works in well-lit, ventilated and climate-controlled office environment with routine office equipment; some equipment has moving mechanical parts.

Noise level in the work environment is typical for an office and/or medical clinic environment.

PAY:

$21-$23/hr