Overview

The Referral Specialist works with patients requiring a referral, to ensure patient’s referral needs are fulfilled for specialty service office visits. Processes referrals, authorizations and pre-certifications for patients, to ensure timely reimbursement.

Responsibilities

• Gather, verify, and process referrals, authorizations, and pre-certifications by working closely with physician(s), patients, and payers.

• Communicate detailed information and answers patients' questions regarding their health care plan; provide answers to billing and insurance clarification questions.

• Set up appointments, coordinate clinic visits, and any special arrangements such as transportation, interpreter services, specialty care, etc.

• Coordinate flow of information between medical clinic and referral authorization department to secure a valid referral for clinic patient.

• Enter referrals, documents communications and action into the system, as appropriate.

• Notify physician(s) and patient when referral is denied, or if additional information is needed.

• Develop and maintain database of referral physician offices preferred by each physician within the clinic.

• Assist Practice Manager with complaint resolution and solutions related to patient referrals.

• Perform other duties as assigned by the practice manager or physician.

Qualifications

Qualifications

• High school diploma or equivalent required.

• 2 years of progressively responsible related experience in a healthcare environment required.

Pay Range

$14.78 - $20.33 /hour

We are an equal opportunity/affirmative action employer.