Clinical Referral Specialist (Medical Referrals and Diagnostics)

Location: Knoxville, TN, USA

Company

Covenant Medical Group is an employed and managed medical practice organization of Covenant Health providing coordinated care across East Tennessee through more than 300 physicians and advanced practice providers in 20 communities.

What you will do

• Schedule inpatient and outpatient tests, procedures, specialty appointments, and other provider-directed services.
• Create and register patient charts, verify patient information, submit insurance eligibility, and document activities in the electronic health record.
• Complete referral and pre-certification forms, obtain insurance authorizations, and add authorization details to the electronic health record.
• Coordinate procedure dates, times, locations, patient instructions, and appointment notifications with patients, providers, facilities, and hospital staff.
• Maintain referral, diagnostic, testing, and appointment logs with follow-up verification in the tracking database.
• Support team orientation, training materials, workflow documentation, meetings, committees, and quality improvement initiatives.

Requirements

• One to two years of experience in referrals and diagnostics with pre-certification experience.
• Medical terminology knowledge is required.
• Knowledge of insurance-plan, hospital, outpatient-facility, and ambulatory-practice requirements.
• Knowledge of ICD-10 and CPT coding, along with basic computer skills.
• Education equivalent to a high school diploma or GED through formal education and/or relevant work experience; a related bachelor's degree may be preferred.
• No licensure is required.

Culture & Benefits

• Full-time schedule of 80 hours per pay period.
• Day shift.
• Team-based collaboration with patients, physicians, nursing staff, and other care team members.
• Annual required education and participation in departmental goals, policies, safety standards, and quality improvement.