About this role
The Patient Engagement Access Center (PEAC) Referral Management Specialist is an important role for processing internal, incoming, and external referrals for all ambulatory services. In this role you will obtain prior authorizations, schedule patients, work inbound and outbound phone calls. You will also engage in conversations with patients on their responsibilities for copayment, prepayment, and any outstanding balance.
WHO WE ARE
Franciscan Health is a leading healthcare organization dedicated to providing exceptional patient care and promoting health and wellness in our community. Our mission is to ensure that every patient receives the highest quality of care through innovation, compassion, and excellence. With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers who provide compassionate, comprehensive care for our patients and the communities we serve.
WHAT YOU CAN EXPECT
Ensure current and standardized referral policies and workflows are followed and utilized on a regular basis.
Prioritize referrals by their urgency and address them in a timely manner.
Ensure complete demographic, insurance information, and appropriate/pertaining clinical information is sent to referred specialists.
Contact insurance companies to ensure prior approval requirements are met.
Present necessary medical information such as history, diagnosis, and prognosis to insurance companies if deemed necessary to prove the medical necessity of services.
Review details and expectations about the referral with ordering providers and patients.
QUALIFICATIONS
Required High School Diploma/GED
2 years Medical referrals, healthcare, and or prior authorization Required
TRAVEL IS REQUIRED:
EQUAL OPPORTUNITY EMPLOYER
It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.
Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.
Franciscan Alliance is committed to equal employment opportunity.
Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.
Other facts
About Franciscan Alliance, Inc.
A trusted leader in providing faith-based, integrated health care, Franciscan Alliance brings together the latest technology, innovative procedures and the brightest, most compassionate people to serve our patients in Indiana, Illinois and Michigan. Throughout our 13 hospitals and many medical practices, we offer a number of nationally recognized Centers of Health Care Excellence.
Our health care system carries forth Christ’s healing ministry and strengthens the Catholic health care mission by: Providing a broad, coordinated continuum of health care services with an emphasis on improving the health of persons and communities; Treating the mind, body and spirit with holistic and comprehensive medical options; Developing creative structures for health care delivery; Being advocates for those in need; Identifying and developing our sisters and laity for Franciscan leadership.
What you'll do
- The Referral Management Coordinator processes internal, incoming, and external referrals for ambulatory services. Responsibilities include obtaining prior authorizations, scheduling patients, and engaging in conversations regarding copayments and outstanding balances.
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