Join our team as a day shift, full-time, Referral Program Coordinator in Tulsa, OK.

Fulfilling your purpose begins here:

People First, Always. Here's how we take care of our people:

• Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, 401k retirement plan with company match, employee assistance program and more

Your team is bigger than your department:

• Utica Park Clinic, founded in 1982, is a multi-specialty medical group with more than 300 employed physicians and advanced practice providers representing over 25 specialties across 80 plus clinics in Oklahoma.
• We believe healthcare is a team sport and every player has something to contribute. We show compassion, celebrate differences and treat one another with respect.

• Responsible for processing internal, incoming, and external referrals for Ambulatory services, procedures, and medications.
• Obtain prior authorizations, schedule patients, work inbound and outbound phone calls, and communicate with patients via online chat.
• Ensures complete demographic, insurance information, and appropriate/pertaining clinical information is sent to referred specialists.
• Contacts insurance companies to ensure prior approval requirements are met.
• Presents necessary medical information such as history, diagnosis, and prognosis to insurance companies if deemed necessary to prove the medical necessity of services.
• Reviews details and expectations about the referral with ordering providers and patients.
• Requests new referrals to be ordered when applicable.
• Identifies and utilizes community resources; establishes relationships with servicing providers and personnel.
• Receive requests for prior authorization through the electronic health record (EHR) and/or via phone or fax and ensure that they are properly and closely monitored.
• Serves as point of contact for patients and specialists for any questions or concerns.
• Process referrals and submit medical records to insurance carriers to expedite prior authorization processes.
• Manage correspondence with insurance companies, physicians, specialists, and patients as needed, including documenting in the EHR as appropriate.
• Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.
• Review the accuracy and completeness of the information requested and ensure that all supporting documents are present.

Job Requirements:

• High School Diploma or GED