Job Description:The Referral Coordinator provides the administrative functions needed to support a smooth, efficient referral this position you will:Assist the utilization review and case management nurse with management of referrals an monitoring or institutional patients.Day-to-Day Responsibilities:u2022 Receiving and processing referral requests as the insurance companyu2022 Working on approvals and denials for the referrals within the policyu2022 If something is out of network, working with the medical director/UM nurses to establish if there is something in network that can be approved or if they can make an exception for the out of network request Skills:Medical, Health care, Prior authorization, Medical billing, Coding, Claim, Insurance, Medical claim, Insurance verification, Medical record, Utilization review, Medical coding, Epic, Cpc, Cpt coding, Icd9 Skills Details:2+ years tenured experience with referral processingu2022 High school diploma or equivalent; high school level command of spelling, grammar, basic composition, math and/or basic vocational completion of equivalent technical training.u2022u00a0Two years' experience in medical related field (patient serviceu00a0rep, member services, medical billing, review services, referral coordinator, etc.)u2022 Degree as LPN or health data services coder preferred.u2022 Familiarity with computers.u2022 Previous experience in UR, health plan, or managed care environment.u2022 Ability to frequently shift thinking and work processes between various lines of business, insurance plans, medical group practices and computer systems.u2022 Knowledge of ICD9-CPT and DRG codes.u2022 Medical terminology knowledge.u2022 Excellent customer service skills Experience Level: Intermediate - Expert Leve
ACE Hardware 
Seattle, WA 
