**Primary City/State:**
Scottsdale, Arizona
**Department Name:**
Family Medicine-Pinnacle
**Work Shift:**
Day
**Job Category:**
Administrative Services
The future is full of possibilities. At Banner Health, we’re excited about what the future holds for health care. That’s why we’re changing the industry to make the experience the best it can be. If you’re ready to change lives, we want to hear from you.
**Newest primary care clinic in Scottsdale, opening January 2025!**
Banner Pinnacle Peak Family Medicine will be located in the beautiful City of Scottsdale, providing care for patients and their families over the course of their lifetime. Our physicians work with patients of all ages and provide primary care services. Our staff and providers form deep and meaningful partnerships with patients by delivering important preventative care, helping patients manage conditions and offering support and guidance when health symptoms arise.
As a Referral Specialist, you will be part of a new team focused on providing exceptional customer service to our patients. You will coordinate referral orders for the continuation of treatment which includes scheduling patient appointments with specialty physician services, diagnostics, and follow-ups, verifying insurance coverage, and providing all pertinent clinical information to the payor authorization and facility/specialist prior to the services being rendered. You will have the opportunity to learn and grow professionally at a brand new facility, while making a positive difference in the lives of patients.
**This is a full time day shift position working Monday through Friday between the hours of 7:00am - 5:00pm** (40 hours per week - exact start time to be determined). Your pay and benefits are important components of your journey at Banner Health. This opportunity includes the option to participate in a variety of health, financial, and security benefits.
At Banner Medical Group, you'll have the opportunity to perform a critical role in the community where you practice. Banner Medical Group provides both primary and specialty care throughout the communities in which Banner Health operates. We do this in a variety of settings - from smaller group practices like our Banner Health Clinics in Colorado and Wyoming, to large multi-specialty Banner Health Centers in the metropolitan Phoenix area. We currently have more than 1,000 physicians and more than 3,500 total employees in our group and are seeking others to enhance our ability to deliver our nonprofit mission of providing excellent patient care.
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.
MINIMUM QUALIFICATIONS
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.
Employees working at Banner Scottsdale Sports Medicine, second floor must possess an Arizona Fingerprint Clearance Card at the time of hire and maintain the card for the duration of their employment.
PREFERRED QUALIFICATIONS
Previous knowledge of managed care concepts. Working knowledge of medical terminology and ICD-9 and CPT codes.
Additional related education and/or experience preferred.
**EEO Statement:**
EEO/Female/Minority/Disability/Veterans (https://www.bannerhealth.com/careers/eeo)
Our organization supports a drug-free work environment.
**Privacy Policy:**
Privacy Policy (https://www.bannerhealth.com/about/legal-notices/privacy)
EOE/Female/Minority/Disability/Veterans
Banner Health supports a drug-free work environment.
Banner Health complies with applicable federal and state laws and does not discriminate based on race, color, national origin, religion, sex, sexual orientation, gender identity or expression, age, or disability