Revenue & Referral Intake Specialist
Company: Legacy Health
Location: Portland
Posted on: April 24, 2024
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Job Description:
Overview
You know that your job is about much more than gathering referral
and payer information. As a Revenue and Referral Intake Specialist,
you are the important link between patients and physician
referrals. You are the calm presence that provides all parties with
the information they need for the best possible experience. You
treat all parties with the dignity that is a hallmark of the Legacy
community. If this describes you, we'd like you to consider this
opportunity.
The Revenue and Referral Intake Specialist (RRIS) provides support
to patients, providers, and staff for a wide variety of complex
tasks such as initial patient registration, scheduling
evaluation(s), referral, insurance authorization, charge and coding
review. -
Legacy Good Samaritan Medical Center in Northwest Portland is known
for its specialty programs and clinical excellence. Legacy Good
Samaritan features nationally renowned doctors in cancer care,
kidney transplantations, neurology, ophthalmology, weight-loss
surgery, robotic surgery, rehabilitation and more, plus Oregon's
only 24-hour urgent care that's located alongside an emergency
room, with access to emergency care if needed.
Responsibilities
REFERRALS/ PRIOR AUTHORIZATION:
Processing of all referrals and prior authorizations (hereafter
referred to as 'referral') to ensure timely handling in order to
meet the department's financial, customer service and regulatory
standards. -
Provides education and customer service to providers, staff and
patients regarding the department referral process.
Provides data entry and clerical support for the referral process
for both pre-paid and fee-for-service health plans.
Understands each health plan's guidelines, benefits and basic risk
models.
Understands and follows department's referral processes and
procedures.
Performs insurance verification and authorization including
eligibility checks and complex phone calls to insurance companies
to determine patient coverage
Performs ongoing insurance reauthorization as needed
Understands and follows department's referral processes and
procedures.
Identifies and resolves patient, provider, department and insurance
company concerns, requests and problems related to referral
issues.
CHARGE CAPTURE:
Monitors charge capture process to ensure timely handling in order
to meet the department's financial, customer service, and
regulatory standards.
Provides assistance and direction to providers and staff on
missing, incomplete or inaccurate charges.
Assists providers and staff in assigning appropriate Diagnosis and
CPT codes and researching problems and/or concerns as needed. -
Reviews charges and documentation to ensure appropriate use of
CPT/Diagnosis coding practices. - Acts as a liaison between
providers and revenue cycle departments.
Verifies that billable visits have charges attached.
Works assigned Charge Review Work Queue's and inpatient
reconciliation report in a timely manner.
Acts as liaison between department staff, providers and billing
department.
ACCOUNT AND PATIENT ISSUES:
Handles person-to-person patient inquiries regarding referral
issues. Follows up with patient and other key players until issues
are resolved.
Identifies and resolves patient, physician, department and
insurance company concerns, requests and problems related to
referral issues.
Problem solves issues in a professional manner.
Works cooperatively with other staff to resolve issues for patients
and providers.
SCHEDULE EVALUATION(S) AND REGISTRATION:
The RRIS schedules evaluation appointment(s) for a patient
following the guidelines of the scheduling protocol for the
respective Legacy Program.
PROFESSIONAL BEHAVIOR:
Maintains the respect and confidence of others, including
physicians, customers, patients and coworkers, by exhibiting
professional appearance, proper conduct, punctual attendance,
dependability and a positive attitude.
Meets established guest relation's standards of professional
behavior and confidentiality.
Greets and directs patients, visitors and other employees as per
department procedures.
Provides customer service by phone or in person in a prompt,
courteous and complete manner.
Responds to requests for information courteously and
efficiently.
Takes complete, accurate and timely telephone and verbal messages
in a professional manner.
Presents professional image to customers and staff in a pleasant
and helpful manner.
Takes on special responsibilities and projects in areas as
requested.
Acts as liaison to communicate departmental information to
customers regarding department operations.
OTHER:
Additional functions may include but is not limited to:
Independently initiates required reports.
Communicates swiftly with Supervisor or Manager at the site if work
load issues are resulting in a delay of charge review workqueue(s),
authorizations, timely processing of referrals and or
scheduling
May assist with cash handling.
May float to other departments as needed to maintain core staffing
at managers discretion to cover similar roles and or
responsibilities (e.g., registration or scheduling). -
Qualifications
Education:
Associate's degree in business or healthcare, or equivalent
experience, required.
Experience:
Standard office computer and keyboarding experience required.
Skills: -
Excellent verbal and written communication skills. -
Attention to detail, accuracy and organizational skills. -
Knowledge of medical terminology. -
Keyboard skills and ability to navigate electronic systems
applicable to job functions.
Knowledge of CPT and ICD-10 coding preferred.
Knowledge of insurance and managed care practices preferred.
LEGACY'S VALUES IN ACTION: -
Follows guidelines set forth in Legacy's Values in Action.
Equal Opportunity Employer/Vet/Disabled
Keywords: Legacy Health, Beaver Creek , Revenue & Referral Intake Specialist, Other , Portland, Oregon
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