Legacy Health Revenue & Referral Intake Specialist Equal Opportunity Employer/Vet/Disabled US-WA-VANCOUVER Job ID: 25-42573 Type: Regular Full-Time Vancouver Oncology Overview

You know that your job is about much more than gathering referral and payer information. As a Revenue and Referral Intake Specialist, you are the important link between patients and physician referrals. You are the calm presence that provides all parties with the information they need for the best possible experience. You treat all parties with the dignity that is a hallmark of the Legacy community. If this describes you, we'd like you to consider this opportunity.

The Revenue and Referral Intake Specialist (RRIS) provides support to patients, providers, and staff for a wide variety of complex tasks such as initial patient registration, scheduling evaluation(s), referral, insurance authorization, charge and coding review. 

Responsibilities

REFERRALS/ PRIOR AUTHORIZATION:

Processing of all referrals and prior authorizations (hereafter referred to as 'referral') to ensure timely handling in order to meet the department's financial, customer service and regulatory standards. 

Provides education and customer service to providers, staff and patients regarding the department referral process.

Provides data entry and clerical support for the referral process for both pre-paid and fee-for-service health plans.

Understands each health plan's guidelines, benefits and basic risk models.

Understands and follows department's referral processes and procedures.

Performs insurance verification and authorization including eligibility checks and complex phone calls to insurance companies to determine patient coverage

Performs ongoing insurance reauthorization as needed

Understands and follows department's referral processes and procedures.

Identifies and resolves patient, provider, department and insurance company concerns, requests and problems related to referral issues.

CHARGE CAPTURE:

Monitors charge capture process to ensure timely handling in order to meet the department's financial, customer service, and regulatory standards.

Provides assistance and direction to providers and staff on missing, incomplete or inaccurate charges.

Assists providers and staff in assigning appropriate Diagnosis and CPT codes and researching problems and/or concerns as needed. 

Reviews charges and documentation to ensure appropriate use of CPT/Diagnosis coding practices.  Acts as a liaison between providers and revenue cycle departments.

Verifies that billable visits have charges attached.

Works assigned Charge Review Work Queue's and inpatient reconciliation report in a timely manner.

Acts as liaison between department staff, providers and billing department.

ACCOUNT AND PATIENT ISSUES:

Handles person-to-person patient inquiries regarding referral issues. Follows up with patient and other key players until issues are resolved.

Identifies and resolves patient, physician, department and insurance company concerns, requests and problems related to referral issues.

Problem solves issues in a professional manner.

Works cooperatively with other staff to resolve issues for patients and providers.

SCHEDULE EVALUATION(S) AND REGISTRATION:

The RRIS schedules evaluation appointment(s) for a patient following the guidelines of the scheduling protocol for the respective Legacy Program.

PROFESSIONAL BEHAVIOR:

Maintains the respect and