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Care Connection Associate, Full Time, Day Shift - Referral Center

Company: Adventist Health NW
Location: Kailua
Posted on: May 12, 2022

Job Description:

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 mission.

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 Quality Award.

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 Associate who:

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.

Essential Functions:

* 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 goals.
* 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:

Education:

* 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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