**Primary City/State:**
Fort Collins, Colorado
**Department Name:**
Ortho Joint Center
**Work Shift:**
Day
**Job Category:**
Administrative Services
**Primary Location Salary Range:**
$19.06 - $28.60 / hour, based on education & experience
In accordance with State Pay Transparency Rules.
Great careers are built at Banner Health. We understand that talented health care professionals appreciate having options. We are proud to offer our team members many career and lifestyle choices throughout our network of facilities. Apply today, this could be the perfect opportunity for you.
At **The Joint Replacement Center** , we strive to provide excellent clinical management, clear and ongoing communication to our patients as well as evidence-based, high quality surgical care. We put the latest developments in evidence-based medicine to work to achieve the best outcomes for you and your family.
As a **Referral Specialist** on our team, we offer a customer-focused team in a friendly work environment and career growth opportunities. You'll work alongside healthcare professionals dedicated to providing patients a positive experience. You'll apply your established healthcare experience to coordinate referral orders with the provider schedules and complete prior authorization for specialty services, diagnostic testing, and injections.
**Schedule: Monday - Friday, 8am-5pm**
At Banner Medical Group, you'll have the opportunity to perform a critical role in the community where you practice. Banner Medical Group provides both primary and specialty care throughout the communities in which Banner Health operates. We do this in a variety of settings - from smaller group practices like our Banner Health Clinics in Colorado and Wyoming, to large multi-specialty Banner Health Centers in the metropolitan Phoenix area. We currently have more than 1,000 physicians and more than 3,500 total employees in our group and are seeking others to enhance our ability to deliver our nonprofit mission of providing excellent patient care.
POSITION SUMMARY
This position is responsible for coordinating referral orders for a continuation of treatment, such as specialty services and diagnostic testing within a primary care practice. This position provides all pertinent clinical information needed for the payor authorization and the facility or specialist prior to the services being rendered. The position is responsible for tracking and managing all referrals with the intention and outcome to close any patient care gaps, along with providing documentation to promote team awareness.
CORE FUNCTIONS
1. Schedules appointments for specialty physician services and diagnostic testing per provider request and communicates with the patient on a timely basis for all scheduling requirements
2. Acts as a liaison between patients, providers and staff members for patients’ referral and follow up needs. Provides prompt and professional service for the patients by assisting in educating patient/family and assisting patients with external resources when needed.
3. Provides all pertinent clinical information needed for the payor authorization, the facility or specialist prior to the services being rendered by verifying coverage, obtaining authorization and communicating with receiving facilities
4. Tracks and manages all referrals by monitoring outstanding referrals at 30/60/90 day intervals and following up with patients if appointments are not kept
5. Applies knowledge of medical terminology and maintains up to date knowledge of insurance environment. Utilizes internal and external resources to seek knowledge about regulations regarding various payor sources
6. Collaborates with outside referral sources and other community resources. Maintains an updated list of community resources and networks with colleagues to develop additional referral sources
7. This position has frequent communications with patients, physicians, staff, and third party payers. The position must work with and understand the concepts of managed health care and be able to prioritize tasks within established guidelines with moderate supervision
MINIMUM QUALIFICATIONS
High school diploma/GED or equivalent working knowledge.
Possesses 1 year of direct patient interaction/experience in a medical, insurance, or healthcare related industry.
Knowledge of HIPAA regulations. Strong customer service focus and willingness to problem solve. Effective verbal and written communication skills and the ability to manage competing priorities. Must be proficient with commonly used office software.
PREFERRED QUALIFICATIONS
Previous knowledge of managed care concepts. Working knowledge of medical terminology and ICD-9 and CPT codes.
Additional related education and/or experience preferred.
**Anticipated Closing Window (actual close date may be sooner):**
2025-04-12
**EEO Statement:**
EEO/Female/Minority/Disability/Veterans (https://www.bannerhealth.com/careers/eeo)
Our organization supports a drug-free work environment.
**Privacy Policy:**
Privacy Policy (https://www.bannerhealth.com/about/legal-notices/privacy)
EOE/Female/Minority/Disability/Veterans
Banner Health supports a drug-free work environment.
Banner Health complies with applicable federal and state laws and does not discriminate based on race, color, national origin, religion, sex, sexual orientation, gender identity or expression, age, or disability