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Referral Specialist - OBGYN 5280, Highlands Ranch-39205University Staff

Description

University of Colorado Anschutz Medical Campus

Department: Community Practice

Job Title: Referral Specialist - OBGYN 5280, Highlands Ranch

Position #: 00845794 – Requisition #:39205

Job Summary:

The Referral Specialist is responsible for providing efficient, effective, quality customer service through a variety of duties, including, but not limited to, referral management, completing internal and external referral processes, and obtaining authorization from health plans and other Utilization Management (UM) entities for referrals. Also responsible for entering all referral and authorization information into EPIC and communicating outcomes to the patients, specialists, and other providers. Complies with established company policies and procedures, HIPAA Privacy Rules, and the University of Colorado School of Medicine Confidentiality Policy. Ensures clear and timely communication with patients, colleagues, and providers in a variety of clinical department(s). Assists in overall department work that may include overflow from other departments and/or locations.

Key Responsibilities:

• Runs daily referral reports to create a work list and monitor referrals in place.

• Processes referrals according to departmental goals and accepted protocols, including referrals from current departments and other departments as directed.

• Verifies insurance eligibility and benefits from all resources, including eligibility lists or direct contact with insurance companies – e-verification or by telephone.

• Enters referral information into EPIC using correct coding procedures.

• Documents sufficient referral detail into EPIC so it is clear what was requested, what occurred, what was approved, and who was notified.

• Notifies patients of the referral process and authorization decisions; verifies patient understanding.

• Notifies referral provider of authorizations in a timely manner.

Work Location:

Onsite – this role is expected to work onsite and is located in Highlands Ranch, CO.

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