Care Connection Associate, Full Time, Day Shift - Referral Center
Company: Adventist Health NW
Posted on: May 12, 2022
Adventist Health is more than an award-winning health system. We
provide whole-person care to our communities and champion the
greater good - from the operating room to the boardroom, we are
driven by our unique passion to live God's love through health,
wholeness and hope. From Oregon to Oahu, we have a calling to
always do more. Now is your chance to apply your passion to our
Located minutes from Lanikai Beach in Windward Oahu, Adventist
Health Castle is nestled at the base of the beautiful Ko'olau
mountain range. More than just a beautiful campus, AHCS also one of
five organizations nationwide to receive the 2017 Baldrige National
Featuring a full-service medical center, Castle offers a wide range
of inpatient, outpatient, and home-based services, with over 1,000
employees and staffed by more than 300 physicians. Located just
outside of Kailua, AHCS serves all of O'ahu and is the primary
health care facility for the Windward side of the island.
We're looking for someone to join our team as a Care Connection
Manages incoming and outgoing referrals from Imaging, primary and
specialty providers in a timely and professional manner; schedules
appointments according to practice policy; maintains positive
relations with referral sources; schedules appointments from third
party electronic referral systems, fax, email and web requests; and
participates in marketing to referring practices. Provides quality
customer service & patient financial responsibilities to patients,
referring physicians, visitors and internal customers by obtaining
insurance authorization and benefit verification for imaging
procedures and specialty referrals.
* Processes inbound and outbound referrals, verifies referrals are
correctly ordered according to protocols in the EHR. Obtains
benefit verification and necessary authorizations (referrals,
pre-certification) prior to patient arrival for all ambulatory
visits, procedures, injections and radiology services.
* Uses online, web-based verification systems and reviews real-time
eligibility responses to ensure accuracy of insurance eligibility.
Verifies patient demographic information and insurance eligibility
including coordination of benefits; updates and confirms as
necessary to allow processing of claims to insurance plans.
* Serves as system navigator and point of contact for patients and
families, with patients and families having direct access for
asking questions and raising concerns. Occasionally assumes
advocate role on the patient's behalf with the carrier to ensure
approval of the necessary supplies/services for the patient in a
timely fashion. Assists patient in problem-solving potential issues
related to the healthcare system, financial or social barriers
(e.g., request interpreters as appropriate, transportation services
or prescription assistance).
* Maintains satisfactory productivity rates and ensures the
timeliness of referral and scheduling while maintaining work queue
* Collaborates effectively with Care Connection Center associates
and responds to provider (internal and external) and support staff
questions, requests and concerns regarding the status of patient
referrals, care coordination or follow-up status.
* Performs other job-related duties as assigned.
You'll be successful with the following qualifications:
* High School Education/GED or equivalent: Preferred
* Associate's/Technical Degree or equivalent combination of
education/related experience: Preferred
Keywords: Adventist Health NW, Honolulu , Care Connection Associate, Full Time, Day Shift - Referral Center, Other , Kailua, Hawaii
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