- High School Diploma or GED
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.
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.
Job Requirements / Qualifications
Education / Accreditation / Licensure (required & preferred):
High school diploma or equivalent required.
Experience (required and preferred):
2 years of progressively responsible related experience in a healthcare environment required.
Requisition ID: 2019-R0236048
Shift: Day Job
Market: CHI St. Luke's Medical Group