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Referral Specialist /Medical Assistant - Grove City Ohio
Company: Mount Carmel Health System Location: Grove City, Ohio
Posted On: 04/24/2024
Employment Type: Full time Shift: Description: Referral Specialist/ Medical AssistantWhy Mount Carmel? With five hospitals , over 60 free-standing outpatient clinics , a college of nursing , a Medicare Advantage plan , and extensive outreach and community wellness programs, Mount Carmel Health System serves more than a million patients in central Ohio each year, and we've been a pillar of this community for more than 130 years. As a proud member of Trinity Health , one of the nation's largest Catholic healthcare delivery systems, our network of caring spans 22 states, 94 hospitals, and 133,000 colleagues nationwide. We know that exceptional patient care starts with taking care of our colleagues, so we invest in great people and all that we ask in return is that you come to work ready to make a difference and do the right thing. What we offer: - Competitive compensation and benefits packages including medical, dental, and vision coverage
- Retirement savings account with employer match starting on day one
- Generous paid time off programs
- Employee recognition incentive program
- Tuition/professional development reimbursement
- Relocation assistance (geographic restrictions apply)
- Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing
- Mount Carmel offers DailyPay - if you're hired as an eligible colleague, you'll be able to see how much you've made every day and transfer your money any time before payday. You Deserve To Get Paid Every Day!Why Columbus? The nation's 14th largest city, Columbus, Ohio is one of the fastest growing major metropolitan areas in the Midwest - ranked for population growth, for job growth, for wage growth, and real estate market. And with a vibrant blend of professional sports, world-class attractions, creative cuisines, and a flourishing music and arts scene, you'll never be found wanting for entertainment and experiences to call your own in Columbus. Learn more at ! About the job:In accordance with the Mission and Guiding Behaviors; the Centralized GME Ambulatory Referral Specialist maintains, confirms and/or secures referrals, authorizations, or precertification's needed on physician/clinic services. Verifies accuracy and completeness of admitting information on outpatient referrals and obtains authorizations when needed. Maintains an updated tracking log. This position will also function as a Medical Assistant by adhering to the State of Ohio scope of practice to administer direct care to patients, functioning under the direction of the provider or registered nurse. They will follow all policies and procedures including Mount Carmel Health System and department specific policies and procedures.What you'll do:
- Contacts insurance carriers after verifying information to secure benefit coverage, policy limitations, precertification, etc. for customers.
- Conducts follow-up calls as necessary to physician offices, patients, and third party payers to complete pre-certification process.
- Contacts relevant internal staff to update status, coordinate resolution/correction of issues, sends records to insurance companies and determines whether a denied authorization should be appealed.
- Schedules appointments and tests: pre-certifies patients for insurance coverage; sets up referral contacts; reviews requisitions (labs and x-rays) for completeness
- Prepares and organizes department: inspects exam rooms for cleanliness and equipment for condition.What we're looking for:
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