CMA/RMA Referral Clerk

Job Description

SUMMARY:

Under general supervision, the CMA/RMA Referral Clerk is responsible for coordinating the care and treatment of patients through the process of scheduling referrals & pre-certifications.  Will also perform nursing duties as needed. 

 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

*Include the following. Other duties may be assigned.*

  • Obtain insurance referrals for patient care.
  • Schedule patients for hospital surgeries and diagnostic procedures.
  • Give instructions and/or explain procedures to patients as directed by healthcare provider.
  • Pre-certify patients for surgeries and/or hospital stays.
  • Verify insurance coverage and referral needs.
  • Schedule patients for hospital surgeries, admissions, and diagnostic procedures, obtaining pre-certification, prior authorization, and/or referral if necessary.
  • Obtain and submit necessary information, files, and reports to appropriate personnel.
  • Referral follow up, make sure provider receives records from specialists.
  • Receive and prepare patients for examination, obtaining blood pressure, pulse rate, temperature, and weight.
  • Able to perform nursing duties, if needed, to maintain the flow of the clinic.
  • Obtain authorizations for medications.
  • Abide by the rules and regulations as set forth by the State of Tennessee.

 

EDUCATION AND/OR EXPERIENCE:

Graduation from a standard high school or GED. Diploma or equivalent from a one year college or technical school and currently certified as a CMA or RMA. Two or three years’ related experience and/or training in a medical office with a background knowledge of insurance; or equivalent combination of education and experience. 

QUALIFICATION REQUIREMENTS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed  are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EOE/AA/M/F/Disability/Vet

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