Job Description

Summary:

This position covers both Clare and Gladwin



The primary function of this position shall be to coordinate the timely completion, monitoring, and submittal of all incoming and outgoing third-party payer referrals for all referrals to the system sleep department. The position will work closely with providers, insurers, and patients in obtaining, resolving, documenting, and communicating referral preauthorization's for specialist services and/or diagnostic testing procedures. The position will be a primary liaison with third party/managed care insurers to stay informed of the latest changes and developments with preauthorization referral procedures. Inclusive within this responsibility and equally important will be the maintenance of the incoming and outgoing referral databases within the appropriate electronic medical record system.


Responsibilities:

(25%)*Works with the providers and office staff to complete third party referral authorization forms accurately and timely, transmitting some via mail, fax, telephone, or electronically on a frequent basis.



(25%)*Coordinates investigation into and responds to disputed or incomplete referral requests on an occasional basis.



(25%)*Enters and tracks incoming and outgoing referrals on the appropriate electronic medical record system; compiles monthly statistical reports on referral utilization for management reporting purposes on an occasional basis.



(25%)*Schedules patients for the system sleep department on an as needed basis.



OTHER DUTIES AND RESPONSIBILITIES:


Other duties as assigned.


Certifications and Licensures:

n/a


Required Education:

Education:

HIGH

Equivalent Experience:

Education Specialization:

Essential:

true




Other Information:

EXPERIENCE, TRAINING AND SKILLS:


Two to four years medical office experience, excellent interpersonal/customer relations skills, knowledge medical terminology, knowledge of third payer rules, and medical record charting/documentation experience required.



Established written and verbal communication skills, good organization and prioritization skills, proficient computer user; experienced in Windows, Word Processing, and medical practice software, and able to work independently required.



Experienced Medic Computer User and database application knowledge and skills preferred.



Ability to work well in a team environment - cover coworker duties as needed, participate in department teams, offer suggestions for workflow improvement.



MyMichigan Health is a technology driven organization and employees need to demonstrate competency in Microsoft Windows.



An employee may be required to participate in further learning opportunities offered by MyMichigan Health.



PHYSICAL/MENTAL REQUIREMENTS AND TYPICAL WORKING CONDITIONS:


Exposure to stressful situations, including those involving public contact, as well as trauma, grief and death.



Able to wear personal protective equipment that includes latex materials or appropriate substitute if required for your position.



Is able to move freely about facility with or without an assisted device and must be able to perform the functions of the job as outlined in the job description.



Overall vision and hearing are necessary with or without assisted device(s).



Frequently required to sit/stand/walk for long periods of time. May require frequent postural changes such as stooping, kneeling or crouching.



Some exposure to blood borne pathogens and other potentially infectious material. Must follow MyMichigan Health bloodborne pathogen and TB testing as required.



Ability to handle multiple tasks, get along with others, work independently, regular and predictable attendance and ability to stay awake.



Overall dexterity is required including handling, reaching, grasping, fingering and feeling. May require repetition of these movements on a regular to frequent basis.



Physical Demand Level: Sedentary. Must be able to occasionally (0-33% of the workday) lift or carry 0-10 lbs.