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Providence Health & Services Referral Coordinator in Portland, Oregon

Description:

Providence is calling a Referral Coordinator - Pmg Referral Operations (1.0 FTE, Days) to Mother Joseph Plaza Portland in Portland , OR.

Apply today! Applicants that meet qualifications will receive a text message with some additional questions from our Modern Hire system.

We are seeking a Referral Coordinator - Pmg Referral Operations who will be responsible for the documentation and implementation of policies and procedures relating to the Medical Management Process. This position serves as a resource to PMG providers and staff in regard to referral requirements for contracted insurance carriers, confirms contracted status of requested specialist or provides alternative suggestions if the requested specialist is not contracted with the patients insurance plan. This position represents the first line of communication with physicians and the office staff. This position receives all pertinent referral information and forwards requests to the insurance plan through different electronic mediums (fax, web-based applications and telephone) as indicated. This position is also required to review referrals for basic elements and refer to appropriate staff. This position supports phone queues as assigned, i.e. Physician Answer Line, Bridge Access Line.

In this position you will have the following responsibilities:

  • Coordinate the referral management process for assigned clinic(s), which includes responding to provider referral calls, determining and relaying benefit information as it relates to referral processing

  • Obtain pre-certification/authorization from insurance companies, including extensions requested by physicians

  • Answer patient questions regarding surgical procedures, testing, referrals to specialists, etc.

  • Process all paperwork related to PMG Medical Management Program

Qualifications:

Required qualifications for this position includes:

  • Two (2) years of working experience in a medical clinic

  • Knowledge of CPT and ICD-9 and ICD-10 coding

  • Knowledge of insurance billing and managed care

  • Data processing skills, such as, word processing

  • Excellent verbal communication and interpersonal skills

Preferred qualifications for this position include:

  • Two (2) years of medical Assistant experience

About Providence in Oregon

As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.

The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,

"Providence will provide the best care and service to every person, every time."

Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.

We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit

https://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Patient Services

Location: Oregon-Portland

Req ID: 297364

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