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Clinic Primary Care Group Referral Nurse
| Title: |
Clinic Primary Care Group Referral Nurse
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| Department: |
Clinic
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| Primary Duties: |
Coordinates Specialty Clinic and Imaging Services patient referrals at the direction of the referring CHC Provider and/or their nurse
Gather all clinical information from chart, including CPT and drug codes, which may be used for the course of treatment.
Call insurance company or payor to verify insurance, deductible, out of pocket max, facility information.
Ensures requested patient referrals are logged, tracked
Ensures referrals requiring precertification have been pre-certified prior to the procedure being performed
Ensures referrals requiring conservative therapy treatment be completed prior to the procedure being performed have been completed and appropriately documented
Works with Medical Records to ensure referral results are received from referral source; reviewed/signed by the ordering CHC and subsequently filed in the patients medical record
Monitors referrals sent out of the MMC Physician Services Network that could/should have been seen by MMC Specialty Clinic Providers and submits a monthly report to the Vice-President of Clinic and Outpatient Services reflecting same.
Works with Imaging Services department leadership to ensure all expensive Imaging Services referrals have appropriate procedure pre-authorization, conservative treatment documentation prior to such procedures being performed to ensure payment for same and;
Other duties as may be assigned by the Clinic Nurse Manager
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| Listing Date: |
1/18/2012
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| Status: |
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| Schedule: |
Days
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| Weekend: |
Mon-Fri
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| Qualifications: |
Education: Graduated from an accredited school of nursing. Associate degree preferred Experience: Prior nursing experience preferred.
Required licensure/certification: LPN or RN, CPR certified
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| Pay: |
Excellent Salary and Benefit package
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| Contact: |
Human Resources
TammyeLyseng@catholichealth.net
701-774-7454
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