Clerical/General Office Job In Lantana, Florida
Referral Clerk - Lantana ClinicNext Steps... Apply Now
To be the Health Care Safety Net for Palm Beach County
The Health Care District of Palm Beach County is an integrated public health system established by the voters as a special taxing district. The safety-net system is an equal opportunity employer of approximately 1,300 employees. The Health Care District provides challenging and fulfilling employment opportunities through its health coverage programs for uninsured residents, a pharmacy operation, a nationally-recognized Trauma System that includes the Trauma Hawk Aeromedical Program, adult and pediatric services at the C. L. Brumback Primary Care Clinics throughout the county, a School Health program which staffs registered nurses in nearly 170 public schools, short-term or long-term inpatient care at the Edward J. Healey Rehabilitation and Nursing Center, and the county’s only public hospital, Lakeside Medical Center, which serves the rural, western Glades’ communities. For more information, visit www.hcdpbc.org.
LinkedIn - www.linkedin.com/company/health-care-district-of-palm-beach-county
C.L. Brumback LinkedIn - www.linkedin.com/company/c-l-brumback-primary-care-clinics
Twitter - www.twitter.com/healthcaredist
General Statement of Job
This position is responsible for accurately and timely completing and tracking both internal and external referrals. This position acts as a liaison and scheduling assistant between CL Brumback Primary Care Clinics and the referred to entity, and is accountable to ensure appropriate authorizations for referred services, both in and out of network.
Specific Duties and Responsibilities
Analyzes health service requests for accuracy and completeness of information based on referral guidelines.
Assemble required information concerning patient's clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to Registration Specialist.
Contact internal department, external organization, or insurance company, as appropriate, to ensure prior authorization requirements are met, if required. Present necessary medical information such as history, diagnosis and prognosis, as needed.
Reviews details and expectations about the referral with the patient. Assist patients in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, and transportation services.
Follow-up on pending referrals and send certified letters to non-compliant patients.
Keep current update to Clinics Contacted Insurance Listing in order to facilitate referral and authorization processing.
Establish and maintain relationships with identified service providers.
Verifies participation and contracted provider status.
Prioritizes health service requests in order to meet 72-business hour turnaround standard.
Inputs member and authorization information into the current operating system. Maintains ongoing tracking of referrals through completion.
Troubleshoots calls from providers concerning authorizations and explanations of benefits.
Maintains and updates comprehensive knowledge of medical terminology.
Ensures adherence of patient confidentiality and HIPAA compliance on all documentation and maintains secure recordkeeping.
Responsible for answering phone calls in a timely, professional and courteous manner.
Emergency duty may be required of the incumbent that includes working in Red Cross shelters or to perform other emergency duties including, but not limited to, responses to threats or disasters, man-made or natural. Additionally, incumbents are required to perform emergency response and management duties for Palm Beach County as required.
This job description reflects the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a complete description of all the work requirements and expectations that may be inherent in the position. The omission of specific statements of duties does not exclude them from the position. Management of the Health Care District of Palm Beach County reserves the right to assign duties not listed herein as necessary to accomplish the goals of the organization.
High school diploma or GED required.
Three (3) to five (5) years experience in a physician’s office, healthcare, or insurance company setting, that demonstrates knowledge of medical terminology, coding, billing and customer service. Must have basic computer skills and experience with keying claims or authorizations.
The Health Care District is an Equal Employment Opportunity Employer and maintains a Drug Free Workplace. Veterans preferred. Qualified individuals with disabilities who require an accommodation to participate in the application process or candidates with other questions should contact Human Resources.
Dedicated to the Health of the Community The Health Care District of Palm Beach County is an integrated public health system established in 1988 as a special taxing district that is an equal opportunity employer of approximately 1,000 employees. The Health Care District's mission is to ensure access to a comprehensive health care system and the delivery of quality services for the residents of Palm Beach County. The Health Care District provides challenging and fulfilling employment opportunities through its health coverage programs for uninsured residents, a nationally recognized Trauma System, adult and pediatric services at the four C. L. Brumback Primary Care Clinics, a School Health program which staffs registered nurses in nearly 170 public schools, a pharmacy operation, a long-term skilled nursing and rehabilitation center, and its acute care hospital, Lakeside Medical Center, in rural western Palm Beach County.