Referral Processor II - On Call

THIS POSTING REPRESENTS TWO POSITIONS
Performs a variety of procedures to process complex outside medical referrals, functions as a liaison, and works independently. Ensures timely accurate processing resulting in making members/patients and their needs a primary focus of one's actions; accurate department processes to ensure quality processing. Considers how timely and accurate referral processing will affect members.
Essential Functions:
Processes complex outside medical referrals; reviews referral for completeness and requests additional information as necessary; verifies member eligibility, ensures appropriate review nurse approval is obtained when necessary (codes diagnoses and procedures) and enters information into system.
Maintains relationships with vendors, physicians and members with regard to questions and problems with referrals, including keeping outside providers updated with pertinent information to process referrals (Researches each referral to ensure service requested is a benefit for the member. Gathers data on interregional members and verifies eligibility status by contacting member's home region.). Performs other duties as assigned by management.
Basic Qualifications:
Experience
Four (4) years of previous experience in a healthcare industry.
Minimum of six (6) months experience authorizing/denying referral requests.
Education
High school graduation or equivalent.
License, Certification, Registration
N/A
Additional Requirements:
Demonstrated ability to read/interpret provider orders and to apply medical coding procedures using CPT-4 and ICD-9.
Demonstrated customer service skills, customer focus abilities and the ability to understand Kaiser Permanente customer needs.
Typing speed of 35 w.p.m.
10 key by touch.
Preferred Qualifications:
Medical terminology preferred.
This position requires attention to detail, multi tasking and strong computer skills.

Don't Be Fooled

The fraudster will send a check to the victim who has accepted a job. The check can be for multiple reasons such as signing bonus, supplies, etc. The victim will be instructed to deposit the check and use the money for any of these reasons and then instructed to send the remaining funds to the fraudster. The check will bounce and the victim is left responsible.

More Jobs

Referral Processor II
Aurora, CO Kaiser Permanente
Mortgage Loan Processor II - Altavera
Denver, CO Computershare Inc
Mortgage Loan Processor II - Altavera
Littleton, CO Computershare, Inc
Teller - On Call Teller - Westminster
Westminster, CO Keybank National Association
Business Banking Officer II
Denver, CO Bank of the West