Putnam - Referral Coordinator/Certified Medical Assistant - Putnam Medical Associates (00326)

ProHealth Physicians/Putnam Medical Associates has an immediate opening for a friendly, customer focused and detailed oriented Referral Coordinator/Certified Medical Assistant to join our team. The approximate hours will be from Monday through Friday 8:00-4:00.
Support ProHealth Physicians practices by performing all work associated with referrals, pre-certifications and prior authorizations. This includes following required processes to communicate with health plans and coordinate care between primary care and specialist and other health care providers.
Process referrals, pre-certifications, and prior authorizations. 2. Do all necessary documentation to meet the needs of providers, health plans, and patients. 3. Track referrals to assure all required timelines are met or exceeded. 4. Monitor referral, pre-certification and prior authorization queues and follow up with providers and/or patients as necessary until the authorizations are completed. 5. Update the referral, pre-certification, or prior authorization in the electronic medical record and payer systems and in other systems as required, including appropriately annotating and updating orders and requests. 6. Follow up with practices, providers, patients and/or specialists to ensure that referrals, pre-certifications, or prior authorizations are completed in a timely manner. 7. Ensure that specialist reports are received by the primary care provider and are scanned into the electronic medical record. 8. Communicate with patients, specialists, payers, and practice staff. 9. Maintain knowledge of payer requirements and ProHealth policies and workflows. 10. Collaborate with all members of the care team and payer teams to ensure referral, pre-certification, and prior authorization requirements and patient needs are met. 11. Serve as ProHealth's subject matter expert in all matters related to referrals, pre-certifications, and prior authorizations. 12. Participate in workflow improvements and development to support changes in the business and/or addition of new payer requirements. 13. Work as a medical assistant, depending on the needs of the office; rooming patients (vitals, ekg ), performs quality control checks on equipment, patient care documentation in the electronic medical record, coordinate patient care as directed by physicians/providers, organize exam and treatment rooms, stock and clean rooms, sterilizes instruments, carries out standing orders consistent with ProHealth policies and procedures, .
High school completion or GED. ? Certified Medical Assistant, with a minimum of 3 years of experience in a related position with a health care provider or health plan. ? Computer proficiency required, experience with electronic medical records strongly preferred. Additional requirements include: strong customer service and problem solving skills, and ability to work independently and meet deadlines.
To be considered for this position, applicants need to meet the qualifications listed in this posting.
ProHealth Physicians is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Diversity creates a healthier atmosphere: ProHealth Physicians is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
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