Patient Access-Referral Specialist bei Rivers Health

Rivers Health is seeking a Full-Time Referral Specialist  to perform the following duties:

The following is a summary of the essential functions of this job.  The

incumbent may perform other duties, both major and minor, that are not

mentioned below; and specific functions may change from time to time.

1. Verifies and documents correctly insurance coverage for all

     Radiology exams requiring prior authorization.

1. Contacts insurance companies to obtain prior authorizations for

     ancillary exams prior to scheduling exam/service.  Confirms in-

     network and insurance benefits prior to scheduling.

1. Must have knowledge and understanding of CPT4 and ICD9 coding.

1. Verifies medical necessity for all ancillary exams requiring prior

     authorizations.

1. Verifies and documents benefits for coverage for all ancillary exams

     requiring prior authorizations.

1. Once authorization is obtained, contacts central scheduling office

     for appointment date and time.

1. Promotes a positive image of Physician Practice Services and

     Rivers Health to all patients and public.

1. Follows departmental and hospital policies and procedures as

     required.

1. Demonstrates excellence in customer service skills.

1. Fosters an atmosphere of teamwork and collaboration.

1. Participates in quality improvement activities including serving on

     quality improvement teams.

1. Other duties may be assigned.

1. Complies with Corporate Policies, Departmental Policies and

     Procedures and Personnel Handbook.

1. Will coordinate patient payment with the financial counselor.