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Banner Health Referral Specialist Family Medicine Clinic in Phoenix, Arizona

Primary City/State:

Phoenix, Arizona

Department Name:

Family Practice-Clnc

Work Shift:

Day

Job Category:

Administrative Services

At Banner University Medical Group (BUMG), we’re creating a world class medical organization that brings together a leadership team committed to a physician-focused structure, while navigating the challenges of moving from a volume-based to value-based health care system.

Banner – University Medicine Family Medicine Clinic takes pride in the excellent care patients receive by combining academic training with faculty physicians. The Center’s care includes pediatrics, adolescents, adults, obstetrics/gynecology and geriatrics. We provide preventive care and manage chronic diseases. Family-centered maternity care is unique to our practice. We provide prenatal care, delivery, and newborn care for your baby. The office features 22 exam rooms with specialty areas for colposcopy, IUD insertions and removals, circumcision, skin procedures, joint injections, osteopathic manipulation, toenail removals and counseling.

As a referral specialist at this clinic, you will be coordinating referral orders for the continuation of treatment and providing all pertinent clinical information needed for the payor authorization and the facility or specialist prior to the services being rendered.

This is a full time (40 hours/week), day shift position: Monday - Friday 8:00A-5:00P

University Medical Center Phoenix PBCs Banner - University Medical Center Phoenix is a nationally recognized academic medical center. The world-class hospital is focused on coordinated clinical care, expanded research activities and nurturing future generations of highly trained medical professionals. Our commitment to nursing excellence has enabled us to achieve Magnet™ recognition by the American Nurses Credentialing Center. The Phoenix campus, long known for excellent patient care, has over 730 licensed beds, a number of unique specialty units and is the new home for medical discoveries, thanks to our collaboration with the University of Arizona College of Medicine - Phoenix. Additionally, the campus responsibilities include fully integrated multi-specialty and sub-specialty clinics, and with a new $400 million campus investment, a new patient tower and 2 new clinic buildings will be built.

POSITION SUMMARY

This position is responsible for coordinating referral orders for a continuation of treatment, such as specialty services and diagnostic testing within a primary care 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 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 appointments for specialty physician services and diagnostic testing per provider request and communicates with the patient on a timely basis for all scheduling requirements

  2. Acts as a liaison between patients, providers 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.

  3. 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

  4. Tracks and manages all referrals by monitoring outstanding referrals at 30/60/90 day intervals and following up with patients if appointments are not kept

  5. Applies knowledge of medical terminology and maintains up to date knowledge of insurance environment. Utilizes internal and external resources to seek knowledge about regulations regarding various payor sources

  6. 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

  7. This position has frequent communications with patients, physicians, staff, 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 moderate supervision

MINIMUM QUALIFICATIONS

High school diploma/GED or equivalent working knowledge.

Possesses 1 year of direct patient interaction/experience in a medical, insurance, or healthcare related industry. Knowledge of HIPAA regulations. Strong customer service focus and willingness to problem solve. Effective verbal and written communication skills and the ability to manage competing priorities. Must be proficient with commonly used office software.

PREFERRED QUALIFICATIONS

Previous knowledge of managed care concepts. Working knowledge of medical terminology and ICD-9 and CPT codes.

Additional related education and/or experience preferred.

Banner Health complies with applicable federal and state laws and does not discriminate based on race, color, national origin, religion, sex, sexual orientation, gender identity or expression, age, or disability.

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