Referral Specialist
- Arvada, CO
- $19.67-25.57 per hour
- Permanent
- Full-time
Ensures compliance with managed care, commercial insurance, and public insurance requirements. Submits and tracks referrals. Provides efficient patient flow and service excellence.Responsibilities:
Verifies eligibility and benefits; obtains authorizations for treatment or precertification of high cost drugs. Tracks referrals to ensure compliance with guidelines. Tracks formulary requirements.Responds to third party payors, employers, internal staff, and physician questions. Maintains information on health plan guidelines. Provides training on plan requirements. Obtains Advance Beneficiary Notice (ABN) or Notice of Exclusions from Medicare Benefits (NEMB) if required. Ensures provider compliance with plan guidelines.Ensures confidentiality of patient and institutional information. Provides routine information to customers and relays information appropriately.Monitors patient needs and responds to inquiries. Prepares written reports.Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action.Requirements:
- High School diploma or GED. Preferred: Associate's degree.
- 6 months' experience in healthcare.
- Medical, dental and vision coverage including coverage for eligible dependents
- 403(b) with employer matching contributions
- Time away from work: paid time off (PTO), paid family and medical leave (inclusive of Colorado FAMLI), leaves of absence; start your employment at UCHealth with PTO in your bank
- Employer-paid basic life and accidental death and dismemberment coverage with buy-up coverage options
- Employer paid short term disability and long-term disability with buy-up coverage options
- Wellness benefits
- Full suite of voluntary benefits such as flexible spending accounts for health care and dependent care, health savings accounts (available with HD/HSA medical plan only), identity theft protection, pet insurance, and employee discount programs
- Education benefits for employees, including the opportunity to be eligible for 100% of tuition, books and fees paid for by UCHealth for specific educational degrees. Other programs may qualify for up to $5,250 pre-paid by UCHealth or in the form of tuition reimbursement each calendar year
- UCHealth is a qualifying employer for the federal Public Service Loan Forgiveness (PSLF) program! UCHealth provides employees with free assistance navigating the PSLF program to submit their federal student loans for forgiveness through Savi.