Health Referral and Funding Specialist
Company: Oconomowoc Residential Programs
Posted on: February 13, 2020
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
- 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
- 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
- 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
- Understanding of medical terminology required.
- Two years of work experience in a medical office environment
- Attention to detail and acute organizational skills
- 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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