The purpose of this position is to coordinate the referral process in accordance with benefit guidelines and criteria.
Reviews all referrals for eligibility, expiration date, accuracy and completeness
Tracks and manages all referrals by entering them into the computer system.
Acts as a liaison between patients, providers and staff members to direct appropriate cases to the Utilization Management staff.
Works cooperatively with both internal and external customers in assisting members and providers with referral related issues.
Participates in Prior Authorization phone queue as part of daily assignment, in addition to departmental break, lunch and PTO coverage.
High school diploma/GED or equivalent working knowledge.
Experience typically gained through two years experience in a medical office or clinical environment.
Must have knowledge of durable medical equipment. Must possess the ability to communicate sufficiently to perform duties in a manner consistent with departmental scope of services and standards. Basic knowledge of medical terminology, computer literacy and keyboarding skills are required. Knowledge of HMO systems and experience working with the medical referral process required.
Additional related education and/or experience preferred.
Internal Number: 255918
About Banner Health
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.