M Health Fairview has an immediate opening for a Referral Coordinator to support the M Health Fairview Primary Care Clinics.
This is a 1.0 FTE (80 hours per two week pay period), benefits-eligible opening.
Day shift, flexible scheduling, Monday - Friday
This is an Offsite/Remote role supporting primary care clinics across the system. Orientation and training will take place onsite.
The Clinic Referral Representative understands and communicates referral requirements of contracted health plans to patients, physicians/authorized practitioners, and coworkers. Review patient referral information to verify consistency with patients insurance guidelines and utilization of appropriate networks. Ensures that necessary referrals are successfully transmitted to insurance. Acts as a referral liaison between patients, physicians/authorized practitioners, specialists, and health plan representatives.
Directly communicates with and acts as a resource for patients, physicians/authorized practitioners, and specialists regarding managed care insurance contracts and referrals.
Completes referral process:
Enters referrals into the practice management system and/or health plan internet sites.
Edits and updates referrals via appropriate method.
Resolves referral transmission errors.
Investigates and completes referral authorization inquiries.
Documents accurately, clearly, and appropriately in the practice management system, health plan internet sites, and patient medical record.
Identifies out of network referral requests and collaborates with physicians/authorized practitioners to redirect when appropriate, to ensure consistency with patients insurance benefits and utilization of applicable care systems. Communicates and documents referral denials to patients and third party payors.
Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served.
High School Diploma/G.E.D.
None to 1 Year
Vocational/Technical Training or Associate Degree
1 to 3 years prior experience preferred
Prior Epic experience preferred
Must be able to prioritize and work independently.
Previous experience in a health care environment preferred.
Knowledge of third party payors preferred.
Excellent public relations and communication kills.
Together with the University of Minnesota and University of Minnesota Physicians we have created M Health Fairview. M Health Fairview is the newly expanded collaboration among the University of Minnesota, University of Minnesota Physicians, and Fairview Health Services. The healthcare system combines the best of academic and community medicine — expanding access to world-class, breakthrough care through our 10 hospitals and 60 clinics.
Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Fairview is one of the most comprehensive and geographically accessible systems in the state, with 10 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area.
Its broad continuum also includes 60 primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, an integrated provider network and health insurer PreferredOne. In partnership ...with the University of Minnesota, Fairview’s 32,000 employees and 2,400 affiliated providers embrace innovation to drive a healthier future through healing, discovery and education.