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Health Referral and Funding Specialist

Company: Oconomowoc Residential Programs
Location: Lafayette
Posted on: February 13, 2020

Job Description:

T.C. Harris School is a private, employee owned residential and day school for students, ages 6-21, who are diagnosed with Neurodevelopmental Disorders and/or Complex Developmental Trauma Disorders. We are a proud member of ORP Management and its family of companies that provide specialized services and dignified care for children, adolescents, and adults with disabilities. We are now hiring a Health Referral and Funding Specialist that will work at T.C. Harris. An ideal candidate will have experience with researching the provider community to establish relationships with a network of health care providers who accept the varied funding held by our student population, necessary to meet the needs of students at MyPath residential schools in both Wisconsin and Indiana.Knowledge of Medicaid & Medicare, insurance and other health related funding streams a plus. This position will be expected to develop knowledge of each geographic area's provider networks. This position will also be expected to become versed in the various health care funding sources available to our students. Experience with verifying insurance coverage across various insurance entities a plus.

  • Coordinates the process of referring patients to appropriate clinics/practitioners, matching needs and funding sources. Including but not limited to the following: medical specialists (orthopedic, dermatology, gastroenterology, etc.), optometry, dentists/orthodontists, specialty equipment needs, etc.
  • Collects, maintains, and communicates student insurance information to practitioners that provide services along with updating the student database of information as changes occur.
  • Keeps student records current to ensure all parties have accurate information.
  • Supports the synchronizing of appointments, authorizations, and tests within funding source parameters.
  • Ensures appropriate reconciliation, payment, billing, and collection to external responsible parties (or practitioners) for out of pocket expenses.
  • Orchestrates the meeting of student health needs while maximizing use of available health care funding sources and minimize out of pocket expenses for both agencies and external responsible parties.
  • Assists with the completion of paperwork necessary to maintain or obtain health care related funding.
  • Must be at least 21 per licensing regulations
  • A high school diploma or equivalent required. LPN or MA preferred.
  • Previous experience researching and navigating the provider community to establish relationships required.
  • Knowledge of Medicaid & Medicare, health plans, and other funding streams preferred.
  • Experience with insurance verification and referrals preferred.
  • Understanding of medical terminology required.
  • Two years of work experience in a medical office environment required.
  • Attention to detail and acute organizational skills required.
  • Excellent communication and computer skills required.ID: 2018-4844 Shift: 1st External Company Name: TC Harris External Company URL: https://careers.mypathcompanies.com Street: 3700 Rome Drive Post End Date: 3/31/2020

Keywords: Oconomowoc Residential Programs, Lafayette , Health Referral and Funding Specialist, Healthcare , Lafayette, Indiana

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