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Pre-Cert Referral Coordinator AMG Physician Services

Southern Tennessee Regional Health System - Winchester

Responsible for the coordination, processing, obtaining prior authorizations, and requesting reports for a variety of medical referrals for services/procedures as requested by medical providers.

Collaborates with other referral staff, medical providers, and patient care support staff to effectively communicate and ensure successful tracking and coordination of referrals.

Communicates with admitting physician's office, nursing unit staff, and/or other appropriate personnel regarding admission to exchange necessary information and determine placement.

Calls patient's insurance company to verify coverage and benefits; check for prior authorization/precertification requirements prior to any surgery or procedure.

Researches Patient Visit History to ensure compliance with regulatory reimbursement regulations, and completes documentation as required for various managed care contracts.

Send required information with all orders.

Refers patients, based upon established guidelines, to outside agencies for assistance or internally to Benefits Advisor or others when needed for financial guidance.

Job Requirements:

Education: High school diploma or equivalent Required. Associate’s degree Preferred.

Experience: Minimum of two years of precertification or referral coordination experience.

Required Skills: Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.

LifePoint Health is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans’ status or any other basis protected by applicable federal, state or local law.
Full time
Salary Range
$23,000.00 - 31,000.00
per Year
Salary range estimated by
Winchester, TN 37398, US