- Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality and care and concern with each and every internal and external customer.
- Represents the Company in a professional manner, following all Company policies and procedures.
- Uses, protects, and discloses patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
- Responsible for total coordination and processing of all patient referrals for specialty services.
- Follows protocols for proper authorization and processing of all referrals.
- Communicates with the patient on a timely basis for all scheduling requirements.
- Coordinates pre-admission testing requirements with clinic personnel and patient.
- Completes all administrative functions associated with referral activities in a timely manner.
- Enters all referral, hospital, outpatient, DME and other patient specialty health service authorizations into the computer system according to Company policy and procedure.
- Receives consultant reports, maintains documentation, and routes to the appropriate physician promptly.
- Responsible for monitoring all referral reports not received and timely follow-up in accordance with Company policy and procedure.
- Performs other duties as assigned.
- Must have consistent, punctual and reliable attendance.
- Ability to travel to local corporate office for training may be required.
- High School Diploma/GED OR equivalent experience
- 1+ years of experience working in healthcare facility, physician's/medical clinic setting and/or medical insurance company
- Experience with windows based programs including Microsoft Word, Microsoft Excel and Microsoft Outlook
- Must be 18+ years of age or older
- Ability to work our normal business hours of 8:00am - 5:00pm EST. It may be necessary, given the business need, to work occasional overtime .
- Previous medical office experience with referral processing for HMO plans is preferred.
- Knowledge of ICD-10 and CPT codes
- Experience working in a call center
- Previous experience with EMR system
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Care/Referral Coordinator - Orlando, United States - UnitedHealth Group
Description
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale.Join us to start Caring. Connecting. Growing together.The Care/Referral Coordinator is responsible to the Center Administrator and assists with medical management data entry and referral functions.
This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am - 5:00pm EST. It may be necessary, given the business need, to work occasional overtime . Our office is located at 7242 West Colonial Drive, Orlando, FL.
We offer weeks of on-the-job training. The hours during training will be8:00am - 5:00pm EST, Monday - Friday.
Primary Responsibilities:
Required Qualifications
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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