Overview
Join our dynamic healthcare team as a Full Time Referral Specialist, where your expertise will drive seamless patient care coordination and optimize clinical workflows. In this vital role, you will serve as the bridge between patients, healthcare providers, and insurance companies, ensuring accurate referral processing, insurance verification, and adherence to confidentiality policies. Your proactive approach and attention to detail will contribute to delivering exceptional healthcare experiences while maintaining compliance with industry standards. This full-time position offers an engaging environment where your skills make a meaningful difference in patient outcomes and operational efficiency.
Duties
- Manage and process patient referrals efficiently across various medical specialties and services.
- Verify insurance coverage, benefits, and managed care policies to facilitate smooth authorization procedures.
- Accurately document referral details using Electronic Medical Records (EMR) or Electronic Health Records (EHR) systems, ensuring data integrity.
- Conduct insurance verification by reviewing health insurance policies, CPT (Current Procedural Terminology) codes, ICD (International Classification of Diseases) codes such as ICD-9 and ICD-10, and medical coding standards.
- Maintain strict compliance with HIPAA regulations and clinical confidentiality policies when handling sensitive patient information.
- Collaborate with medical office staff to ensure all referral documentation aligns with medical records management protocols.
- Assist in resolving insurance denials or discrepancies related to referrals or authorizations promptly and professionally.
Skills
- Proven experience working in a medical office environment with familiarity in health insurance policies and managed care processes.
- Strong knowledge of HIPAA regulations, medical terminology, and clinical confidentiality policies.
- Proficiency in CPT coding, ICD coding (ICD-9 and ICD-10), and medical coding practices for accurate documentation and billing.
- Experience with EMR/EHR systems for managing electronic health records efficiently.
- Excellent communication skills to liaise effectively with healthcare providers, insurance companies, and patients.
- Ability to verify insurance coverage accurately through health insurance policy review and insurance verification procedures.
- Knowledge of dental office operations is a plus for those with dental office experience; otherwise, experience in medical office settings is essential.
This role is perfect for motivated professionals eager to enhance patient care through meticulous referral management while ensuring compliance with industry standards. If you thrive in fast-paced environments where your attention to detail makes a real impact, we invite you to join our team!
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person
