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Overview Looking to be part of something more meaningful? At HonorHealth, you’ll be part of a team, creating a multi-dimensional care experience for our patients. You’ll have opportunities to make a difference. From our Ambassador Movement to our robust training and development programs, you can select where and how you want to make an impact. HonorHealth offers a diverse benefits portfolio for our full-time and part-time team members designed to help you and your family live your best lives. Visit honorhealth.com/benefits to learn more. Join us. Let’s go beyond expectations and transform healthcare together. HonorHealth is one of Arizona’s largest nonprofit healthcare systems, serving a population of five million people in the greater Phoenix metropolitan area. The comprehensive network encompasses six acute-care hospitals, an extensive medical group with primary, specialty and urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization, community services and more. With nearly 17,000 team members, 3,700 affiliated providers and close to 2,000 volunteers dedicated to providing high quality care, HonorHealth strives to go beyond the expectations of a traditional healthcare system to improve the health and well-being of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The primary contact for patients who contact the Customer Navigation Center regarding ambulatory specialty provider referrals. Primary role is to obtain referral authorizations, optimize care coordination, customer navigation, specialty appointment scheduling and support in-network referrals processing, Drive business to high quality, aligned specialists across our network. Essential Functions Demonstrates high level knowledge of insurance requirements for referral authorization and care coordination Consistent coverage verification for patient appointments, including specialty referrals to HonorHealth Medical Group, PSAs, ACOs and aligned specialists in our network. Gather appropriate clinical documentation to support the referral authorization and subsequent specialty appointment scheduling. Keep current on all knowledge base articles and workflow changes posted in Teams Channels Document both ordering and receiving provider by name and location within Referral Management System and EPIC so patient journey can be properly monitored, data reporting can we accurate and any gaps identified early. Understand and utilize provider scoring for quality, access to care, location, insurance compatibility when sending referrals to specialists. Make the “best fit” recommendation when not otherwise indicated by ordering provider. Escalate any issues with provider data in Referral Management System or EPIC platforms so provider data can be quickly updated. Escalate any care availability or customer service issues with provider offices to Supervisor for follow up. Utilize internal and external resources to seek knowledge about insurance plans. Send proactive messages to both patient and ordering/ receiving providers about referral processing statuses. Meet productivity metrics and quality KPIs on a daily/ weekly basis. Performs other duties as assigned.Education Associate's Degree or medical assistant certification - Preferred High School Diploma or GED - RequiredExperience 2 years of call center experience - Required Other Typing a minimum of 45 words per minute (WPM) - Required Other Basic knowledge of insurance plans and requirements Knowledge of physician specialties and hospital services offered Knowledge of medical terminology - Required Other Bilingual in Spanish (conversation) - PreferredLicenses and Certifications Successful completion of competency module (Level 2) upon hire - Required Qualifications Education High School Diploma or GED Required Experience 2 years of call center experience Required Other Typing a minimum of 45 words per minute (WPM) Required Other Basic knowledge of insurance plans and requirements Knowledge of physician specialties and hospital services offered Knowledge of medical terminology Required Licenses and Certifications Successful completion of competency module (Level 2) upon hire Required