Job Summary
We are seeking a proactive and detail-oriented Referral Specialist to join our healthcare team. In this vital role, you will serve as a key connector between patients, healthcare providers, and insurance companies, ensuring seamless coordination of referrals and authorizations. Your expertise will help facilitate timely access to specialized care while maintaining compliance with healthcare regulations. This position offers an exciting opportunity to contribute to improved patient outcomes through efficient communication, accurate documentation, and thorough knowledge of medical billing and insurance processes. If you thrive in a fast-paced environment and are passionate about delivering exceptional customer service in healthcare, we want to hear from you!
Responsibilities
- Manage referral requests by verifying patient eligibility and insurance coverage using electronic health records (EHR) systems and other platforms.
- Obtain necessary prior authorizations from insurance providers by understanding health insurance policies, managed care protocols, and insurance verification procedures.
- Coordinate with healthcare providers to ensure accurate CPT coding, ICD-9, ICD-10, and ICD coding for procedures and diagnoses.
- Maintain strict adherence to HIPAA regulations and clinical confidentiality policies when handling medical records and patient information.
- Communicate effectively with patients, providers, and insurance companies to clarify referral requirements and resolve issues promptly.
- Track referral statuses, follow up on pending authorizations, and update electronic health records accordingly.
- Assist in medical billing processes by ensuring proper documentation of services rendered and coding accuracy for reimbursement purposes.
Experience
- Prior experience working in a medical office or healthcare setting is required, with familiarity in medical terminology, medical records management, and office procedures.
- Demonstrated knowledge of health insurance policies, managed care systems, and the insurance prior authorization process is essential.
- Proficiency in Microsoft Office applications (Word, Excel) as well as experience with Electronic Health Records (EHR) or Electronic Medical Records (EMR) systems is necessary.
- Strong understanding of HIPAA compliance standards and clinical confidentiality policies must be maintained at all times.
- Excellent customer service skills with the ability to communicate clearly and professionally across diverse audiences.
- Knowledge of medical coding (CPT, ICD-9/10), medical billing practices, and insurance verification processes will enhance your effectiveness in this role.
Join us as a Referral Specialist where your dedication ensures patients receive the care they need efficiently while supporting our commitment to excellence in healthcare delivery!
Pay: $19.00 - $22.50 per hour
Benefits:
- 401(k) matching
- Dental insurance
- Employee discount
- Flexible schedule
- Health insurance
- Paid time off
Work Location: In person
