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Referral Specialist
Referral Specialist-November 2024
Aurora
Nov 19, 2024
About Referral Specialist

  Description

  Summary:

  Ensures compliance with managed care, commercial insurance, and public insurance requirements. Submits and tracks referrals. Provides efficient patient flow and service excellence.

  Work Schedule: Full Time Days

  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.

  6 months' experience in healthcare.

  The pay range for this position is: $19.67 - $25.57 / hour. Pay is dependent on applicant's relevant experience.

  UCHealth offers a Five Year Incentive Bonus to recognize employee's contributions to our success in quality, patient experience, organizational growth, financial goals, and tenure with UCHealth. The bonus accumulates annually each October and is paid out in October following completion of five years' employment.

  UCHealth offers their employees a competitive and comprehensive total rewards package:

  Full medical, dental and vision coverage

  Retirement plans to include 403(b) matching

  Paid time off. Start your employment at UCHealth with PTO in your bank

  Employer-paid life and disability insurance with additional buy-up coverage options

  Tuition and continuing education reimbursement

  Wellness benefits

  5 year incentive bonus

  Full suite of voluntary benefits such as identity theft protection and pet insurance

  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 also qualify for up to $5,250 pre-paid by UCHealth or in the form of tuition reimbursement each calendar year

  Loan Repayment:

  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.

  At UCHealth, we do things differently

  We believe in something different: a focus on the individuality of every person. In big ways and small, we exist to improve the extraordinary lives of all those we serve. As Colorado's largest and most innovative health care system, we as a team deliver on the commitment to provide the best possible experience for our patients and their families. We foster a true human connection and give people the freedom to live extraordinary lives. A career at UCHealth is more than a job, it's a passion.

  Going beyond quality requires the perfect balance of talent, integrity, drive and intellectual curiosity. We are looking for individuals who recognize, like us, that the world of medicine is ever-changing and are motivated to do what is right, not what is easy. We support creativity and curiosity so that each of us can find the extraordinary qualities within ourselves. At UCHealth, we'll do everything in our power to make sure you grow and have a meaningful career. There's no limits to your potential here.

  UCHealth always welcomes talent. This position will be open for a minimum of three days and until a top applicant is identified.

  Be Extraordinary. Join Us Today!

  UCHealth recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an affirmative action/equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual's race, creed, color, religion, gender, national origin or ancestry, age, mental or physical disability, sexual orientation, gender identity, transgender status, genetic information or veteran status. UCHealth does not discriminate against any "qualified applicant with a disability" as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.

  AF123

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