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Posted: 16-Nov-23
Location: San Antonio, Texas
Salary: Open
Internal Number: 16063301
Summary:
This position is responsible for coordinating the entire referral process (obtaining order from physician, obtaining insurance authorization from the insurance company/payor, scheduling the appointment for the patient with a physician who accept the particular insurance, notifying the patient of the appointment, completing renewal authorizations with physicians office and payor) for a 35 physician practice. Researches problem referral claims or requests for payment and corrects. Ensures physicians coding and Dx are appropriate for proper referral and coverage by insurance company. This position is also responsible for knowing various insurance plans and coverages for the patient to ensure proper payment. Responsible to teach nursing associates and physicians all changes within insurance plans for referral and authorization process. Must be up to date with all CPT and ICD-9 coding to process proper referral. Must have clinical background knowledge to appropriately support referral when communicating with insurance companies.
CHRISTUS Santa Rosa Health System is about people. People we meet and care for; people whose lives we enhance, and those whose lives we save. CHRISTUS is about the people who work here: our award-winning medical staff, dedicated housekeeping staff, compassionate nurses and patient-focused ancillary staff. We're about people who need us, from small bumps to massive trauma, no matter their economic bracket. We're about the people of San Antonio, New Braunfels, and all the South Texas communities we serve. Since 1869, CHRISTUS Santa Rosa Health System has grown and flourished just as South Texas has grown. We remain the only Catholic faith-based, non-profit health care system in San Antonio and New Braunfels. Our healing ministry now includes five full-service hospitals with 1,159 licensed beds, and a number of specialty centers.
If you are looking to join a rapidly growing faith-based organization that encourages professional development, we want you to become a part of the CHRISTUS Santa Rosa family!
Requirements:
- High School Diploma or equivalent is required.
- Minimum 3 years office experience in a healthcare setting required.
- Expert knowledge of managed care benefit plans with at least 1 year specializing in a referral-based clinic or physician's office.
- Medical assistant certification from an approved technical school preferred.
Work Type:
Full Time
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