"Referral Specialist - OBGYN 5280, Highlands Ranch"

Referral Specialist - OBGYN 5280, Highlands Ranch

University of Colorado Anschutz Medical Campus

Department: Community Practice

Job Title: Referral Specialist - OBGYN 5280, Highlands Ranch

Position #: 00845794 - Requisition #:39205

Job Summary:

The Referral Specialist is responsible for providing efficient, effective, quality customer service through a variety of duties, including, but not limited to, referral management, completing internal and external referral processes, and obtaining authorization from health plans and other Utilization Management (UM) entities for referrals. Also responsible for entering all referral and authorization information into EPIC and communicating outcomes to the patients, specialists, and other providers. Complies with established company policies and procedures, HIPAA Privacy Rules, and the University of Colorado School of Medicine Confidentiality Policy. Ensures clear and timely communication with patients, colleagues, and providers in a variety of clinical department(s). Assists in overall department work that may include overflow from other departments and/or locations.

Key Responsibilities:

• Runs daily referral reports to create a work list and monitor referrals in place.
• Processes referrals according to departmental goals and accepted protocols, including referrals from current departments and other departments as directed.
• Verifies insurance eligibility and benefits from all resources, including eligibility lists or direct contact with insurance companies - e-verification or by telephone.
• Enters referral information into EPIC using correct coding procedures.
• Documents sufficient referral detail into EPIC so it is clear what was requested, what occurred, what was approved, and who was notified.
• Notifies patients of the referral process and authorization decisions; verifies patient understanding.
• Notifies referral provider of authorizations in a timely manner.

Work Location:

Onsite - this role is expected to work onsite and is located in Highlands Ranch, CO.

Why Join Us:

Community Practice Medicine, housed within the School of Medicine at the University of Colorado, is seeking trained medical professionals to join our growing team. With clinics spanning from Longmont to Castle Rock, we offer a wide variety of opportunities. Specialty areas include, but are not limited to: Orthopedics, Vascular Surgery, OBGYN, Internal Medicine, Urology, Psychiatry, and many more!

The University of Colorado Anschutz Medical Campus is a public education, clinical, and research facility serving 4,500 students, and a world-class medical destination at the forefront of life-changing science, medicine, and healthcare. CU Anschutz offers more than 42 highly rated degree programs through 6 schools and colleges and receives over $500 million in research awards each year. We are the single largest health professions education provider in Colorado, awarding nearly 1,450 degrees annually. Powered by our award-winning faculty, renowned researchers, and a reputation for academic excellence, the CU Anschutz Medical Campus drives innovation from the classroom to the laboratory to the delivery of unparalleled patient care.

Why work for the University?

We have AMAZING benefits and offer exceptional amounts of holiday, vacation, and sick leave! The University of Colorado offers an excellent benefits package, including:

• Medical: Multiple plan options
• Dental: Multiple plan options
• Additional Insurance: Disability, Life, Vision
• Retirement 401(a) Plan: Employer contributes 10% of your gross pay
• Paid Time Off: Accruals over the year
• Vacation Days: 22/year (maximum accrual 352 hours)
• Sick Days: 15/year (unlimited maximum accrual)
• Holiday Days: 15/year
• Tuition Benefit: Employees have access to this benefit on all CU campuses
• ECO Pass: Reduced-rate RTD Bus and light rail service

There are many additional perks & programs with the CU Advantage.

Qualifications:

Minimum Qualifications:

• High school diploma or equivalent.
• Two or more (2+) years of patient/client-facing experience.
• Substitution: A combination of education and related technical/paraprofessional experience may be substituted for on a year-for-year basis.

Applicants must meet minimum qualifications at the time of hire.

Preferred Qualifications:

• Associate's degree.
• Previous experience in managed care referrals.
• Previous experience with ICD-10, CPT, and HCPCS coding.
• Two or more (2+) years of referral experience.
• EPIC, Kronos, and HealthStream experience.
• MS Office experience.
• Bilingual, Spanish-speaking.

Conditions of Employment:

• Must be able to work in-person.
• Must be able to travel to alternate locations as assigned.

Knowledge, Skills, and Abilities:

• Strong organizational and personal skills; must have a strong work ethic.
• Strong communication skills, both written and verbal.
• Strong knowledge of medical terminology.
• Ability to maintain a positive attitude with clients, employees, and management.
• Ability to work quickly - individually and as part of a team.
• Ability to read, analyze, and interpret policies, documents, and regulations.
• Must be detail-oriented and maintain excellent organizational skills.
• Must be tech savvy (ability to understand, apply, and benefit from technology).
• Must be able to use basic office equipment.