Referral & Precert Specialist,… at Covenant Health · Location…

Referral & Precert Specialist, Family Clinic of Oak Ridge

Full Time, 80 Hours Per Pay Period, Day Shift

Covenant Medical Group Overview:

Covenant Medical Group is the employed and managed medical practice organization of Covenant Health, providing comprehensive care across East Tennessee. With more than 300 physicians and advanced practice providers in 20 communities, our team delivers expertise across a broad spectrum of specialties from primary care and walk-in clinics to preventive medicine and advanced surgical and subspecialty services. We are committed to offering coordinated, patient-centered care that spans the continuum of health needs, ensuring access to exceptional providers close to home.

Position Summary:

Directs daily operation of scheduling for inpatient/outpatient procedures and services. Obtains any necessary referrals or pre-certifications.

• Schedules inpatient/outpatient tests, procedures and appointments as directed by provider. Documents each scheduled event in detail in the medical record file.
• Accurately completes all forms required for referrals and pre-certifications.
• Knowledge of requirements and guidelines as mandated by insurance plans, hospitals and outpatient facilities.
• Maintains accurate testing, referral and appointment logs with follow-up verification in the referral tracking database.
• Knowledge of ICD-9 and CPT coding and basic computer skills.
• Coordinates date, time and location of procedure/appointment with the patient, facility and provider.
• Communicates appointments as well as special instructions regarding scheduled procedure/appointment with the patient.
• Reports any problems obtaining referrals, pre-certifications or appointments as ordered by the provider.
• Perform other duties as assigned or requested.
• Attends meetings as required and participates on committees as directed.
• Collaborate with the patient, physician and other care team members as part of a team based approach to overall patient care.

Minimum Education:

None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED. Preference may be given to individuals possessing a HS diploma or GED.

Minimum Experience:

Previous referral/pre-certification experience preferred. Medical terminology knowledge a must.

Licensure Requirement:

None

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