Proliance Retina, a division of Proliance Surgeons Inc., is seeking an experienced referral coordinator for a full-time position. This position requires extensive knowledge of private and government payer rules in regards to referrals and prior-authorizations.
Proliance Retina is seeking an experienced referral coordinator for a full-time position. This position requires extensive knowledge of private and government payer rules in regards to referrals and prior-authorizations.
Primary responsibilities include:
Identify, track, and obtain appropriate referrals from insurance and/or PCP for all office visits;
Request prior-authorizations for procedures and surgeries;
Urgent referrals handled as a top priority;
Obtain retro-referrals and authorizations as indicated;
Maintain accurate records, tracking the status and receipt of completed referrals;
Additional billing office tasks may be added to a daily task list as indicated.
At least 2-year experience with referrals and prior-authorizations (highly preferred in ophthalmology);
Knowledge of ICD-10 and CPT coding is required;
Must be up-to-date on all changes in health insurance industry and health exchange programs;
Strong computer and communication skills are a must;
NextGen knowledge is preferred;
Strong attention to detail and concern for completing task correctly and efficiently;
Ability to prioritize responsibilities according to urgency and importance;
Maintains a professional positive attitude at all times;
Ability to remain calm in high-pressure situations.