Associate Referral Representative
The Associate Referral Representative is responsible for processing patient referrals and prior authorizations. Educates the patients on various procedures and benefits, related to the need for referrals. Coordinates referrals with patients and specialist's offices, and process insurance referrals as required. Acts as a liaison between patient, physician, and insurance company, consistently performing activities in a friendly, courteous, and professional manner. Assists patients over the phone using the call center representative standards.
Every Adelante employee will strive to maximize their performance and contribution to Adelante Healthcare and the community we serve every day. Employees are expected to work in a manner that demonstrates a commitment to quality, patient safety, employee engagement, innovation, and the highest standards of personal integrity, professionalism and competence.
OUR CORE VALUES
ESSENTIAL SKILLS AND EXPERIENCE
- Effective verbal and written communication skills and has a professional presence
- Ability to communicate effectively with patients, co-workers, and the public both in person and over the phone
- 0-1 year of medical referral experience and 1 year of customer service experience.
- Knowledge of medical terminology
- Accuracy and attentional to detail
- Ability to prioritize and perform multiple tasks simultaneously
- Must possess strong organization skills
- Be able to work independently and within a team
- Knowledge of MS Office: Particularly Excel, Word, and Outlook
- Computerized database experience
- Effective office skills: typing, faxing, scanning and telephone
- High school diploma or GED from an accredited institution
- Commitment to Adelante Healthcares mission, vision, and values
- Willingness to be cross-trained and learn new skills and responsibilities
- Valid Level One Fingerprint Clearance Card issued by the Arizona Department of Public Safety for all specialty behavioral health locations
NONESSENTIAL SKILLS AND EXPERIENCE
- Experience in community health
The qualifications listed above are intended to represent the minimum skills and experience levels associated with performing the duties and responsibilities contained in this job description. The qualifications should not be viewed as expressing absolute employment or promotional standards, but as general guidelines that should be considered along with other job related selection or promotional criteria.
- Responsible for scanning incoming documents into patients charts accurately
- Sort incoming faxes and correspondence
- Research and verify within patients chart
- Ability to perform work at established production rates
- Maintain effective communication with office staff and providers in all the health centers as needed
- Demonstrates respectful and professional behavior that supports a team-oriented work environment
- Attend staff meetings, in-service meetings, or other required meetings
- Maintains satisfactory attendance, is punctual and works full scheduled shift
- Meeting minimum standards of metric expectations
Additional Duties and Responsibilities
- Other duties as request or assigned
All employees are responsible for promoting and participating in interdisciplinary communication and collaboration to enhance the delivery of quality across the health care system. Employees should maintain an environment which supports and engages patients and co-workers in a caring team based model to promote wellness and improve health outcomes.
Adherence to Compliance and Code of Conduct
All employees are required to comply with Adelante Healthcares written standards, including its Compliance Program and Standards of Conduct, policies and procedures and reporting of any conduct that potentially violates Adelantes legal or compliance requirements. Such compliance will be an element considered as part of the regular performance evaluation.
PHYSICAL DEMANDS AND WORK ENVIRONMENT
The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Physical demands: While performing the duties of this job, the employee may be required to sit for long periods of time, is required to stand, walk, use hands to handle or feel objects, tools or controls; reach with hands and arms; climb steps/stairs; balance; stoop, kneel, crouch or crawl; talk or hear; smell; manage stress as it relates to essential job functions. The employee must frequently lift and/or move up to 25 pounds without assistance, and may occasionally be required to lift or move up to 50 pounds with assistance. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
Work environment: While performing the duties of this job, the employee is exposed to weather conditions prevalent at the time when traveling to various clinic sites. The noise level in the work environment is usually moderate. The employee may be subject to health hazards (contagious diseases, blood borne pathogens, etc.) when working in the clinic area.
In any organization or job, changes take place over time. Although an effort will be made to keep job-related information current, this is not an all-inclusive list of job responsibilities. Adelante Healthcare, Inc. reserves the right to revise or change job duties and responsibilities as the business need arises. In compliance with EEOC 29 CFR part 1630, if the essential functions of this position cannot be performed in a satisfactory manner by the employee, further accommodations shall be made if it does not constitute undue hardships upon this organization.
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Job Status: Full Time
Job Reference #: 39165