| Primary City/State: Glendale, Arizona Department Name: Work Shift: Day Job Category: General Operations Additional Job Description New River Trails Health Center is the flagship ambulatory health center for Banner Health and provides the residents of Phoenix's Northwest Valley a single location for many of their non-acute health care needs. This 130,000 square foot building is Banner's largest health center and will include 128 exam rooms. The health center also allows for immediate access to on-site advanced imaging, lab, pharmacy and will include over 45 providers across 11 different specialties who will provide care to over 132,000 patients annually. We are excited to welcome our first patient on April 26, 2021. Applications will begin being reviewed in late-December, early January. Interviews will begin mid-January. New River Trails will not only be the largest ambulatory health center in Banner, it will be one of the most technologically advanced and innovative. New River Trails' foundation will be built upon collaboration and communication, and one of our main focuses will be providing patients an excellent continuum of care. We are excited to welcome team members who are: -
Excited to utilize new technologies and processes -
Have strong communication skills, both with patients and all team members -
Committed to answering "yes" as requests, ideas, needs for care arise; always eager to find a solution We will all strive to provide the best experience possible and look forward to leveraging revolutionary technology as part of a highly-integrated team. Every single team member at New River Trails will play a vital role in making health are easier so life can be better. POSITION SUMMARY
This position is responsible for coordinating referral orders for a continuation of treatment, such as specialty services and diagnostic testing within a multispecialty practice. This position provides all pertinent clinical information needed for the payor authorization and the facility or specialist prior to the services being rendered. The position acts as a liaison between the patient and the specialty area by navigating the appointment process, and ensuring that proper authorization(s) are obtained for the appointment, to provide a seamless experience for our patients. This position is responsible for tracking and managing all referrals with the intention and outcome to close any patient care gaps, along with providing documentation to promote team awareness.
CORE FUNCTIONS
1. Schedules and/or coordinates the scheduling of appointments for incoming referrals to assigned specialty physician services and/or diagnostic testing per provider request and communicates with the patient on a timely basis for all scheduling requirements.
2. Schedules and/or coordinates the scheduling and authorizations for provider pre-planned in office procedures ordered by assigned specialty(ies).
3. Acts as a liaison between patients, providers, departments and staff members for patients' referral and follow up needs. Provides prompt and professional service for the patients by assisting in educating patient/family and assisting patients with external resources when needed.
4. Collaborates with providers and departments of assigned specialty(ies) to determine all CPT Codes provider will need authorized before appointment.
5. Provides all pertinent clinical information needed for the payor authorization, the facility or specialist prior to the services being rendered by verifying coverage, obtaining authorization and communicating with receiving facilities for incoming referrals as well as pre-planned in office procedures.
6. Reviews upcoming provider schedules to ensure all appointments have appropriate referral and authorizations required for anticipated visits and procedures.
7. Applies knowledge of medical terminology, ICD-10 and CPT Codes and maintains up to date knowledge of insurance environment. Utilizes internal and external resources to seek knowledge about regulations regarding various payor sources.
8. Collaborates with outside referral sources and other community resources. Maintains an updated list of community resources and networks with colleagues to develop additional referral sources.
9. This position has frequent communications with patients, physicians, staff, departments and third-party payers. The position must work with and understand the concepts of managed health care and be able to prioritize tasks within established guidelines with minimal supervision.
MINIMUM QUALIFICATIONS
High school diploma/GED or equivalent working knowledge.
Requires knowledge of medical terminology, ICD-10, CPT Codes and a broad understanding of all common insurance and payor types and authorization requirements, normally acquired over a two or more years of work experience in the healthcare field. Strong knowledge in the use of common office software, word processing, spreadsheet, EMR software are required. Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently. Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences. Knowledge of HIPAA regulations. Strong customer service focus and willingness to problem solve.
PREFERRED QUALIFICATIONS
Previous knowledge of managed care concepts. Working knowledge of medical terminology and ICD-10and CPT codes.
Additional related education and/or experience preferred. |
