Pinnacle Healthcare Consulting · 13 hours ago

Referral and Eligibility Coordinator

United States

Full-time

Remote

Entry Level

$18/hr - $22/hr

2+ years exp

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Responsibilities

Collects and documents critical information accurately and completely. Updates information per policy.

The R&E Coordinator is responsible for the quality, accuracy and completeness of demographic information.

Performs insurance verifications as indicated by company’s policy by utilizing online websites, sources, payer sites, and other tools.

Understands the impact of how this role affects the performance of the revenue cycle as well as the client experience.

Ensures that the verification of eligibility, the coordination of benefits, the procurement of referrals and authorizations are performed proactively and prior to the patient visit and/or claim generation.

Becomes the subject matter expert as it relates to carrier requirements and accurate demographic entries.

Accurately and completely enters information into the Practice Management and Verification Systems (eligibility field) as designated by policy.

Demonstrates knowledge of importance of referring physician and other critical information and is diligent in gathering information.

Utilize various information sources for patient demographic and insurance information such as referring physician office, hospital’s patient accounting department and patient.

Processes full registration for new patients.

Identifies potential payers when patient reports as self-pay.

Utilizes all tools to research for payer prior to reporting balance to collection agency.

Work assigned EHR tasks, e-mails and Work Queues.

Interacts with the patient and others in a professional manner.

Demonstrates confidence and speaks appropriately with patients in gathering information.

Explains COB guidelines to patients as needed.

Works collaboratively with all revenue cycle departments to provide the optimal client experience.

Provides support to others.

Can handle multiple tasks at once.

Attend and actively participate in individual, group and department meetings.

Provide back-up as required to ensure all intake deadlines are met.

Other duties as assigned.

Qualification

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Insurance verificationPatient demographic entryPractice Management SystemsEHR tasksMath skillsWord Processing softwareSpreadsheets