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 accepts the particular insurance, notifying the patient of the appointment, completing renewal authorizations with the physician's 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 the insurance company. This position is also responsible for knowing various insurance plans and coverages for the patient to ensure proper payment. Responsible for teaching 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...