Summary

Obtain referrals, pre-certifications and prior-authorizations via internet, faxing forms, and/or making calls to insurance companies. Schedule all procedures and the necessary pre-certification. Schedule all diagnostic tests and all necessary pre-certification. Follow up on all scheduled referral appointments, diagnostic testing, and procedures; confirming scheduled date/time, and patient notification. Document all referrals, procedures, and diagnostic tests in the appropriate log books and retain the information for review. Obtain Prior Authorizations for medications not included on patient formularies. Verify patient insurance 24 hours prior to scheduled appointment time and troubleshoot/eliminate any patient eligibility issues identified. Act as back-up for the PSR position(s). Perform general office duties such as data entry, filing, etc. May be responsible for Invision/Flowcast registration and other functions as designated. Perform any other duties as directed.

Job description

Job Summary

Obtain referrals, pre-certifications and prior-authorizations via internet, faxing forms, and/or making calls to insurance companies. Schedule all procedures and the necessary pre-certification. Schedule all diagnostic tests and all necessary pre-certification. Follow up on all scheduled referral appointments, diagnostic testing, and procedures; confirming scheduled date/time, and patient notification. Document all referrals, procedures, and diagnostic tests in the appropriate log books and retain the information for review. Obtain Prior Authorizations for medications not included on patient formularies. Verify patient insurance 24 hours prior to scheduled appointment time and troubleshoot/eliminate any patient eligibility issues identified. Act as back-up for the PSR position(s). Perform general office duties such as data entry, filing, etc. May be responsible for Invision/Flowcast registration and other functions as designated. Perform any other duties as directed.

This position is involved in a team-based approach to care. Team members are trained to meet the highest level of function for their role as per the State of Tennessee/Georgia guidelines. Is trained and assigned to coordinate care for patients and to support patients/families/caregivers in self-management, self-efficacy and behavior change. Is trained and assigned to manage the practices' patient population. Participates in the practice's quality improvement process and performance evaluation.

Department Position Summary

Interaction with third party payers and other departments; and communicating with people of a broad socio-economic mix. Strong organizational skills and a commitment to teamwork are essential. Will work closely in a clinical setting involving some stressful situations, personal flexibility; moderate sitting, standing, stooping, bending and moderate work at portable computers required. Will work closely with other physician offices to keep abreast of any new updates or changes with regards to scheduling, registration and referrals.

Requirements

High school diploma
Training for computer competency
Clerical experience and/or hospital experience
Excellent communication skills
Highly organized and detail-oriented
Strong math skills
Great telephone etiquette
Knowledge of general business principles in a related healthcare or business field
Previous experience with appointment scheduling, referrals, patient registration and data entry
Medical terminology course (preferred)
Prior Centricity/Flowcast/Invision/SMS experience (preferred)

Company overview

Erlanger - North Hospital is a key component of the Erlanger Health System, a comprehensive non-profit academic medical center based in Chattanooga, Tennessee. As a community hospital serving the Signal Mountain, Red Bank, and North Chattanooga communities, Erlanger North provides essential healthcare services including 24/7 emergency care, sports and family medicine practices, an inpatient seniors program, and an accredited sleep disorders center. The hospital operates as part of a larger health system that includes multiple hospitals and facilities across a four-state region encompassing southeast Tennessee, north Georgia, north Alabama, and western North Carolina. Erlanger Health System is recognized as a Level I Trauma Center and serves as the primary teaching hospital for the University of Tennessee Health Science Center College of Medicine. With a history dating back to 1889, the system treats over one million patients annually and employs between 5,000-10,000 healthcare professionals across its network. Erlanger North specifically focuses on delivering accessible, high-quality community-based care while benefiting from the resources and expertise of the larger academic medical system.