Top 780 Patient access representative Jobs in Silver Spring, Md

Referral Management (Non-Nurse) Reviewer
Zimmerman Associates, Inc. —Bethesda, MD
- $23.56 an hour
- Microsoft Excel
- Microsoft Outlook
- Customer service
Referral Management (Non-Nurse) Reviewer
Zimmerman Associates, Inc. —Bethesda, MD
- $24.13 an hour
- Microsoft Excel
- Microsoft Outlook
- Customer service
Insurance Authorization and Pre-Certification Specialist
Medical Practice —Odenton, MD
- $21 - $24 an hour
- Full-time
- High school diploma or GED
- In-person
- Medical terminology
Quick Apply
Front Desk Specialist-GYN Surgical Center
Innovations Surgery Center —Rockville, MD
- $22 - $26 an hour
- Full-time
- Private practice
- Surgery
- Customer service
- Disability insurance
- Health insurance
Quick Apply
Medical Receptionist
Southern Maryland Medical Group —Riverdale, MD
- From $17 an hour
- 8 hour shift
- HIPAA
- High school diploma or GED
- Quality control
- Paid holidays
- Health insurance
Quick Apply
Patient Access Representative (Full-time)
Children's National Hospital —Montgomery County, MD
- $20.75 - $40.99 an hour
- Full-time
- Microsoft Excel
- Computer literacy
- HIPAA
4d
Patient Access Representative
Children's National Hospital —Washington, DC
- $20.75 - $40.99 an hour
- Full-time
- Microsoft Excel
- Computer literacy
- Mid-level
- Commuter assistance
- AD&D insurance
Access Call Center Representative
Children's National Hospital —Silver Spring, MD
- $18.54 - $30.89 an hour
- Full-time
- Computer literacy
- Mid-level
- High school diploma or GED
- Commuter assistance
- AD&D insurance
Patient Access ED Registrar, PT Day Shift, Patient Access
Adventist HealthCare —Silver Spring, MD
- $18.40 - $23.48 an hour
- Part-time
- Medical office experience
- Pass drug screening
- High school diploma or GED
- Free parking
- AD&D insurance
Radiology Patient Service Representative 12pm-8:30pm
The Radiology Clinic —Rockville, MD
- $22 - $23 an hour
- 8 hour shift
- Background check
- Spanish
- Mid-level
- COVID-19 protective measures
- Health savings account
Quick Apply
2d
Call Center Agent
Zimmerman Associates, Inc. —Bethesda, MD
- $21.50 an hour
- Microsoft Outlook
- Computer literacy
- Primary Care
Patient Access Representative (Part-time | 12 Hours Per Week)
Children's National Hospital —Washington, DC
- $20.75 - $40.99 an hour
- Part-time
- Microsoft Excel
- Computer literacy
- HIPAA
12d
Representative II, Patient Access- Day Shift
Holy Cross Health —Silver Spring, MD
- $17.89 - $25.04 an hour
- Full-time
- Hospital
- Inpatient
- Mid-level
- Health insurance
- Dental insurance
1d
Patient Service Coordinator MHUC
MedStar Health —Rockville, MD
- $18.70 - $32.72 an hour
- Full-time
- Urgent Care
- High school diploma or GED
- Computer skills
Patient Access Representative (PRN | As Needed)
Children's National Hospital —Prince George's County, MD
- $20.75 - $40.99 an hour
- PRN
- Microsoft Excel
- Computer literacy
- HIPAA
Patient Access Registrar II, Part-Time Rotating Shift, Patient Access
Adventist HealthCare —Silver Spring, MD
- $19.64 - $25.65 an hour
- Part-time
- Hospital
- Pass drug screening
- Inpatient
- Free parking
- AD&D insurance
Patient Access Rep
Children's National Hospital —Washington, DC
- $20.75 - $40.99 an hour
- Full-time
- Microsoft Excel
- Computer literacy
- HIPAA
Representative II, Patient Access- Nights
Holy Cross Health —Silver Spring, MD
- $17.89 - $25.04 an hour
- Full-time
- Hospital
- Inpatient
- Mid-level
- Health insurance
- Dental insurance
10d
Front Desk Receptionist
Maryland Eye Consultants and Surgeons —Silver Spring, MD
- $18 - $24 an hour
- Part-time
- Travel
- In-person
- Reliable transportation
- Paid time off
Quick Apply
Senior Patient Access Representative
Children's National Hospital —Prince George's County, MD
- $21.17 - $42.35 an hour
- Full-time
- Microsoft Excel
- Computer literacy
- Inpatient
- Commuter assistance
- AD&D insurance

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Referral Management (Non-Nurse) Reviewer

Zimmerman Associates, Inc. -
Bethesda, MD

Apply Now

Job Details

$23.56 an hour

Qualifications

Customer communication
Microsoft Excel
Microsoft Outlook
Customer service
Associate's degree
Medical terminology

Full Job Description

Zimmerman Associates, Inc. (ZAI) is seeking to hire multiple Referral Management (Non-Nurse) Reviewers to support our contract with the Integrated Referral Management and Appointing Center (IRMAC), the National Capital Region’s premier authority for appointment coordination and referral management services for beneficiaries within the Defense Health Network.

Pay Rate: $23.56 per hour plus $4.93 Health & Wellness Fringe

Role and Responsibilities:

Referral Management (Non-Nurse) Reviewers will facilitate centralized product line and specialty referrals for Active-Duty Service Members and TRICARE Prime beneficiaries enrolled at Military Treatment Facilities (MTFs) within the National Capital Region.

This is an onsite opportunity

Qualifications / Skills / Experience:

Minimum of an Associate’s degree
At least 2 years of experience in Utilization Management, Referral Management, Authorization/Denials, or Medical Claims Processing/Insurance Referral
U.S. Citizenship required, with the ability to obtain a Public Trust Clearance
Knowledge of medical care criteria such as InterQual, Milliman Ambulatory Care Guidelines, Specialty Referral Guidelines (SRGs), or other evidence-based Military Health System (MHS) guidelines
Familiarity with medical terminology and ability to learn MHS, VA-DOD Sharing Program, TRICARE, HIPAA, and release of medical information protocols
Excellent communication and interpersonal skills
Strong customer service orientation
Understanding of Access to Care Standards within the Direct Care System
Attention to detail, including correct use of deferral codes
Strong organizational skills with ability to prioritize tasks and manage time effectively
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Access, Outlook) and internet navigation

Essential Tasks:

Review and process referrals for administrative and clinical completeness and appropriateness, completing disposition within 24 hours of referral date
Collaborate with appointing centers, case managers, product line nurses, providers, clinics, managed care contractors, and other healthcare team members to ensure appropriate use of Direct Care and civilian network resources
Ensure patients are scheduled with the right provider, at the right time and place
Review compliance with Specialty Referral Guidelines (SRGs) per IRMAC protocols
Complete and return Clear Legible Reports (CLR) to ordering civilian providers within required Return of Favorable Response (ROFR) timelines
Manage telephone, written, and electronic communications regarding specialty appointments and referrals
Monitor and process referral management worklists (e.g., Genesis Work Lists) to ensure timely consult processing
Communicate referral status to patients, including benefit counseling and advocacy resources as needed
Reschedule or redirect patients within 3 days when referrals are disapproved or invalid, advising on other care options and Line-of-Duty issues
Receive and enter ROFR referrals in MHS-GENESIS from Military Contractor Support Centers (MCSC) portals for assigned specialties/product lines, adhering to all timelines and business rules
Verify patient eligibility and update demographics in MHS-GENESIS
Document patient interactions, especially when appointments are refused, and coordinate with Beneficiary Counselor and Assistance Coordinator as appropriate
Coordinate with product line nurses and clinics for special accommodations
Interface with MCSC and multidisciplinary teams to ensure referral appropriateness
Submit referrals to non-network providers for TRICARE Service Center medical necessity reviews
Monitor referral management voicemail and return patient calls within established guidelines
Provide External Provider Referral Online (EPRO) information as requested
Close unused referrals following DHA IPM and NCR Medical Directorate policies, notifying ordering providers accordingly
Orient and train new IRMAC staff on referral processes and timelines
Perform other duties as assigned

Zimmerman Associates, Inc. is an equal opportunity employer. We comply with Federal and State Equal Opportunity laws and consider qualified applicants without regard to race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, veteran status, or any other protected status.

#INDSPN

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Refine Your Search

patient access representative jobs in silver spring, md

Referral Management (Non-Nurse) Reviewer

Referral Management (Non-Nurse) Reviewer

Insurance Authorization and Pre-Certification Specialist

Front Desk Specialist-GYN Surgical Center

Medical Receptionist

Patient Access Representative (Full-time)

Patient Access Representative

Access Call Center Representative

Patient Access ED Registrar, PT Day Shift, Patient Access

Radiology Patient Service Representative 12pm-8:30pm

Call Center Agent

Patient Access Representative (Part-time | 12 Hours Per Week)

Representative II, Patient Access- Day Shift

Patient Service Coordinator MHUC

Patient Access Representative (PRN | As Needed)

Patient Access Registrar II, Part-Time Rotating Shift, Patient Access

Patient Access Rep

Representative II, Patient Access- Nights

Front Desk Receptionist

Senior Patient Access Representative

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