The 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 11 ministries and access points across Indiana, 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. 

High school diploma/GED required; 2 years medical referrals, healthcare, or prior authorization experience required; strong communication and organizational skills; ability to work remotely.

Key Responsibilities

• processing referrals
• obtaining prior authorizations
• scheduling patients

Job Details

• Category: Healthcare Services - Allied Health
• Seniority: Entry Level
• Commitment: Full Time
• Workplace: Remote — Indiana, United States
• Salary: USD 38,584 – 50,169 / year
• Languages: English

About Franciscan Health

A leading Catholic healthcare system providing compassionate, comprehensive care across Indiana. — Industry: Healthcare