About Professional Technical Jobs
By being hired into one of our Professional\Technical jobs at EvergreenHealth, you’ll be a key member of the EvergreenHealth team. Individuals in Professional\Technical careers come from a variety of backgrounds, bringing an assortment of knowledge and skills to every area of our business. Please click on your desired Professional\Technical job below to learn more about the exact qualifications. An opportunity at EvergreenHealth may be waiting for you!
Referral Authorization Coord
Expedites the administrative requirements for patient referral from a primary care provider (PCP) to specialists or specialty services, dealing directly with health plans. Makes decisions and authorizes risk planning referrals, utilizing department and organizational guidelines. Requires daily interaction with patients, staff, healthcare providers and insurance companies.
1. Processes patient referrals from PCP to specialist, working directly with health plans, troubleshooting when necessary.
2. Serves as a point person coordinating information regarding managed care referrals for patients, providers, case managers and other Utilization Management staff.
3. Assigns proper ICD-10 and CPT code(s) to patient referrals.
4. Responsible for communication and dissemination of key managed care contractual information and system processes to patients and staff.
5. Performs other duties as assigned.
REQUIRED for the position:
•Associate’s degree or equivalent combination of education and experience
•3 years of experience in a healthcare insurance or related medical office setting
•Working knowledge of ICD9 and CPT codes
•Ability to be flexible and relate well with others in a professional and pleasant manner
•Knowledge of medical records confidentiality
•Excellent communication skills with a high degree of tact and poise to deal effectively with patients, physicians and hospital staff members
DESIRED for the position:
•Medical Terminology, medical billing and computer skills
•Working knowledge of insurances, Medicare, DSHS, Labor and Industries, and other third party insurances