Referral Advocate

Job Overview

Requirements

• Must have a high school diploma, GED, or equivalent
• One to two years of experience in a clinic or hospital setting required
• Graduate of a Certified Medical Assistant program preferred
• Knowledge of basic office procedures, equipment, and computer systems preferred
• Familiarization with medical terminology and prior health care experience preferred

Work Hours

We are seeking a full-time (40 hr/week) Referral Advocate to work Monday- Friday, 8:30 AM- 5:00 PM

Job Summary

The Referral Advocate assists with various patient-related duties, including prior authorizations for surgeries and radiology, processing referrals, and communicating with insurance companies (by phone or website) and/or patients regarding those authorizations. Additional duties may be assigned by the Director of Clinic Operations.

Essential Job Functions and Responsibilities

This list of duties and responsibilities is not all inclusive and may be expanded to include other duties and responsibilities as management may deem necessary from time to time.

1. Performs prior authorization on all High-End Radiology, Referrals, and surgeries indicated by a physician order.
2. Assists Patient Financial Services department to insure prior authorization requirements are met for upcoming procedures as appropriate.
3. Consistent and accurate documentation in Epic regarding the process of the authorization as well as final documentation upon approval process.
4. Assumes primary responsibility for providing patient teaching / instruction for their follow-up appointments and diagnostic studies, etc.
5. Complete and maintain work queues that pertain to referrals.
6. Adheres to Southwest Health’s value-based behavior standards.
7. Understands and adheres to Southwest Health compliance and HIPAA standards as they appear in the Corporate Compliance Policy, Code of Conduct and Conflict of Interest Policy.
8. Performs other duties and responsibilities as requested or required.

Contact Information

Southwest Health
Attn: Human Resources
1400 Eastside Rd
Platteville, WI 53818
Phone: (608) 342-0998
Email: hr@southwesthealth.org
Fax: (608) 342-5015

Benefits

Southwest Health is truly an outstanding place to work. A full benefit package is available for employees working 20 hours/week or greater which includes: Health, Dental, Vision and Life insurance. Also available are long and short term disability, cell phone discount, flexible spending plan, paid time off, retirement plan with an employer contribution, fitness membership discount as well as use of exercise equipment at the facility.