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    Referral Specialist - Pensacola, United States - Ascension Health

    Ascension Health
    Ascension Health Pensacola, United States

    2 weeks ago

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    Description

    Details


    • Department: ACC Fl Centralized Referral

    • Schedule: 8:00am-5:00pm Monday-Friday

    • Location: Remote

    • _Must be local to the Pensacola, FL area_

    Benefits
    Paid time off (PTO)

    Various health insurance options & wellness plans

    Retirement benefits including employer match plans

    Long-term & short-term disability

    Employee assistance programs (EAP)

    Parental leave & adoption assistance

    Tuition reimbursement

    Ways to give back to your community


    _*Please note, benefits and benefits eligibility can vary by position, exclusions may apply for some roles (for example: Travel, PRN, Short-Term Option, etc.).

    Actual compensation offer will vary based upon role, education, experience, location, and qualifications. Connect with your Talent Advisor for additional specifics._


    Responsibilities


    Do you have experience working with full lifecycle of referrals? We are looking for experience working with referrals with physicians and patients local to Pensacola, FL.

    Communicate with patients, participants and staff to accurately schedule patients for prescribed referral.


    Help patients navigate through their health care needs by assisting with
    referrals, obtaining referral approvals/prior authorization from medical insurance payers, insurance authorizations, scheduling appointments, and answering questions.

    Help patients navigate through their health care needs by assisting with referrals, insurance authorizations, scheduling appointments, and answering questions.


    • Confirm insurance coverage via payer portals and determine necessity for pre-authorization.
    • Obtain authorization and process referrals for services ordered by providers.
    • Schedule appointments as appropriate and within required time-frames and assuring referrals are maintained within appropriate network and/or payer requirement.
    • Remain current on referral policies and procedures, payer requirements, managed care matrix, portals and determines financial responsibility for services to be provided.
    • Communicate with patients, healthcare providers, and third-party service providers regarding insurance coverage and barriers to care.
    • Document detailed information in the patient medical record and any actions taken regarding authorization status, coverage issues, restrictions and appointment details.
    • Notify patients and providers of services requested that are not authorized by insurance.

    Requirements

    Education:

    • High School diploma equivalency OR 1 year of applicable cumulative job specific experience required.
    • Note:
    Required professional licensure/certification can be used in lieu of education or experience, if applicable.


    Additional Preferences

    • Experience in full lifecycle with referrals for physicians and insurance companies
    • Must have experience with obtaining referral approvals/prior authorization from medical insurance payers.
    • Experience working with medical insurance benefits and portals, pre-certification and prior authorizations, clinical documentation, and medical terminology

    Why Join Our Team


    Ascension associates are key to our commitment of transforming healthcare and providing care to all, especially those most in need.

    Join us and help us drive impact through reimagining how we can deliver a people-centered healthcare experience and creating the solutions to do it.

    Explore career opportunities across our ministry locations and within our corporate headquarters.


    Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.

    Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community.

    Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.


    Equal Employment Opportunity Employer


    Ascension will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws.


    For further information, view the EEO Know Your Rights (English) \_EEOC\_KnowYourRights\_10\) poster or EEO Know Your Rights (Spanish) \_EEOC\_KnowYourRightsSp\_10\) poster.


    As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists.

    Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.

    Pay Non-Discrimination Notice \_%20English\)


    Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application.

    Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.


    E-Verify Statement
    This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.


    E-Verify (https:
    //e-\_Participation\_Poster\)
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