Referral Specialist jobs in Colorado

Location: UCHealth Parkview Medical Center, US:CO:Pueblo

Department: One Call Access

FTE: Full Time, 1.0, 80.00 hours per pay period (2 weeks)

Shift: Flex

Pay: $16.07 - $24.10 / hour. Pay is dependent on applicant's relevant experience

Summary:
Ensures compliance with managed care, commercial insurance, and public insurance requirements. Submits and tracks referrals. Provides efficient patient flow and service excellence.

Responsibilities:

• Verifies eligibility and benefits; obtains authorizations for treatment or precertification of high cost drugs. Tracks referrals to ensure compliance with guidelines. Tracks formulary requirements.
• Responds to third party payors, employers, internal staff, and physician questions. Maintains information on health plan guidelines. Provides training on plan requirements. Obtains Advance Beneficiary Notice (ABN) or Notice of Exclusions from Medicare Benefits (NEMB) if required. Ensures provider compliance with plan guidelines.
• Ensures confidentiality of patient and institutional information. Provides routine information to customers and relays information appropriately.
• Monitors patient needs and responds to inquiries. Prepares written reports.
• Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action.

Requirements:

• High School diploma or GED.
• 6 months' experience in healthcare.

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• Full medical, dental and vision coverage
• Retirement plans to include 403(b) matching
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• Employer-paid life and disability insurance with additional buy-up coverage options
• Tuition and continuing education reimbursement
• Wellness benefits
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• UCHealth is a qualifying employer for the federal Public Service Loan Forgiveness (PSLF) program! UCHealth provides employees with free assistance navigating the PSLF program to submit their federal student loans for forgiveness through Savi.

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