At Banner - University Medical Group (BUMG), we're creating a world class medical organization that brings together a leadership team committed to a physician-focused structure, while navigating the challenges of moving from a volume-based to value-based health care system.
As a Referral Specialist on this team, you will use your experience in a busy healthcare/medical office environment processing patient referrals and insurance information. Excellent customer service and communication skills are a must!
Some of the BUMG-Phoenix clinics currently hiring for qualified Referral Specialists are:
Internal Medicine Clinic
Diabetes and Endocrinology Institute
Other clinics in the BUMG-Phoenix family include (but are not limited to):
Heart Institute, Digestive Health, Toxicology, Behavioral Health, Infectious Disease, Lung Institute, Rheumatology, Endoscopy, Musculoskeletal, Concussion Clinic, Integrated Surgery, Urology, Oral Maxillofacial surgery, Trauma Services, Women's Institute, Neuroscience Institute, Wound Care Clinic, Family Medicine Clinic, Bariatric Clinic, Sport Medicine Clinic, Advanced Liver Disease Clinic
These clinics may have openings that you could be considered for in the near future.
All of these clinics are located within walking distance to the Banner University Medical Center in Phoenix (located near 12th and McDowell).
While the start and end times can vary slightly, most of the shifts are full time (40 hours/week), day shift positions: Monday-Friday 8A-5P being the most common.
Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.
University Medical Center Phoenix PBCs Banner - University Medical Center Phoenix is a nationally recognized academic medical center. The world-class hospital is focused on coordinated clinical care, expanded research activities and nurturing future generations of highly trained medical professionals. Our commitment to nursing excellence has enabled us to achieve Magnet(tm) recognition by the American Nurses Credentialing Center. The Phoenix campus, long known for excellent patient care, has over 730 licensed beds, a number of unique specialty units and is the new home for medical discoveries, thanks to our collaboration with the University of Arizona College of Medicine - Phoenix. Additionally, the campus responsibilities include fully integrated multi-specialty and sub-specialty clinics, and with a new $400 million campus investment, a new patient tower and 2 new clinic buildings will be built.
POSITION SUMMARY This position is responsible for coordinating referral orders for a continuation of treatment, such as specialty services and diagnostic testing within a primary care practice. This position provides all pertinent clinical information needed for the payor authorization and the facility or specialist prior to the services being rendered. The position is responsible for tracking and managing all referrals with the intention and outcome to close any patient care gaps, along with providing documentation to promote team awareness.
CORE FUNCTIONS 1. Schedules appointments for specialty physician services and diagnostic testing per provider request and communicates with the patient on a timely basis for all scheduling requirements
2. Acts as a liaison between patients, providers and staff members for patients' referral and follow up needs. Provides prompt and professional service for the patients by assisting in educating patient/family and assisting patients with external resources when needed.
3. Provides all pertinent clinical information needed for the payor authorization, the facility or specialist prior to the services being rendered by verifying coverage, obtaining authorization and communicating with receiving facilities
4. Tracks and manages all referrals by monitoring outstanding referrals at 30/60/90 day intervals and following up with patients if appointments are not kept
5. Applies knowledge of medical terminology and maintains up to date knowledge of insurance environment. Utilizes internal and external resources to seek knowledge about regulations regarding various payor sources
6. Collaborates with outside referral sources and other community resources. Maintains an updated list of community resources and networks with colleagues to develop additional referral sources
7. This position has frequent communications with patients, physicians, staff, and third party payers. The position must work with and understand the concepts of managed health care and be able to prioritize tasks within established guidelines with moderate supervision
High school diploma/GED or equivalent working knowledge.
Possesses 1 year of direct patient interaction/experience in a medical, insurance, or healthcare related industry. Knowledge of HIPAA regulations. Strong customer service focus and willingness to problem solve. Effective verbal and written communication skills and the ability to manage competing priorities. Must be proficient with commonly used office software.
Previous knowledge of managed care concepts. Working knowledge of medical terminology and ICD-9 and CPT codes.
Additional related education and/or experience preferred.
Internal Number: R9480
About Banner Health
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.
To improve the patient experience by providing health care providers; patients and their families; and others with information, education, networking opportunities, and related resources focused on best practices.