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Wellmark Blue Cross and Blue Shield

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Coordinator Referrals - Clinics
DescriptionSummary: Arranges referral appointments for specialists utilizing managed care guidelines and practices. Maintains working knowledge of, and adheres to compliance with, Medicare, Medicaid, and managed care regulations. Arranges referrals as indicated by the provider, utilizing proper insurance referral guidelines and CPT, ICD9 and HCPCS coding. May be required to send necessary lab and ancillary reports. Verifies insurance information, current PCP, and medical necessity for the referral. Obtains authorization for release of medical records.  Obtains insurance pre-certification and authorization as required by the various insurance plans. Notifies the ordering provider of any conflict or delay in scheduli


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