Top 32 Referral specialist Jobs in Wilmington, De

Managed Care Coordinator (Pre-Cert)
First State Orthopaedics —Newark, DE
- From $17 an hour
- Full-time
- Surgery
- OSHA
- Customer service
- Health savings account
- Disability insurance
Quick Apply
Physician Authorization/Referral Specialist I
Nemours —Wilmington, DE
- Full-time
- Writing skills
- HIPAA
- Mid-level
Insurance Verification Specialist
Delaware Orthopaedic Specialists —Wilmington, DE
- $18 - $22 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Medical office experience
- Health insurance
- Dental insurance
Quick Apply
Preregistration Specialist
Penn Medicine —Philadelphia, PA
- Mid-level
- 3 years
- High school diploma or GED
- Tuition reimbursement
Quick Apply
3d
Orthopedic Authorization Liaison
Nemours —Wilmington, DE
- Full-time
- 5 years
- Research
- Mid-level
Global Medicine Business Operations Coordinator
Children’s Hospital of Philadelphia —Philadelphia, PA
- $69,200 - $88,200 a year
- Full-time
- Computer literacy
- Mid-level
- Analysis skills
Quick Apply
Genetics Counselor Assistant-Cardiology
Nemours —Wilmington, DE
- Part-time
- Mid-level
- Bachelor's degree
- 1 year
Financial Counselor - Full Time Days at Pennsylvania Hospital
Penn Medicine —Philadelphia, PA
- Full-time
- Medical office experience
- HIPAA
- Mid-level
- Tuition reimbursement
Quick Apply
Medical Office Referral Coordinator
PA Surgery Group LLC —Philadelphia, PA
- $24 an hour
- Full-time
- Clean driving record
- Dental office
- Surgery
- Paid holidays
- Health insurance
Billing Agent (Contract)
Backpack Healthcare —Philadelphia, PA
- $20 an hour
- Contract
- Remote
- Google Workspace
- Microsoft Excel
- 5 years
Quick Apply
Insurance Coordinator
Specialty1 Partners —Newark, DE
- $19 - $21 an hour
- Dental office
- High school diploma or GED
- US work authorization
- 401(k)
Quick Apply
Insurance Verification Specialist
Chord Specialty Dental Partners —West Chester, PA
- $19 - $23 an hour
- Full-time
- Dental office
- Office
- High school diploma or GED
Quick Apply
Technical Referrals Logistician II
EHS TECHNOLOGIES CORPORATION —Philadelphia, PA
- Mid-level
- 3 years
- High school diploma or GED
Quick Apply
Pre-Encounter Representative
Main Line Health —Paoli, PA
- Part-time
- Hospital
- Customer service
- High school diploma or GED
- Free parking
- Tuition reimbursement
4d
Part-Time Utilization Specialist- OMY
WES Health System —Philadelphia, PA
- $45,000 - $60,000 a year
- Full-time
- Microsoft Excel
- Psychiatry
- Computer literacy
Quick Apply
Dental Eligibility and Insurance Coordinator
Dentistry for Children & Adolescents —Holmes, PA
- $21 - $24 an hour
- Full-time
- Dental office
- Mid-level
- Pediatrics
- Health insurance
- Dental insurance
Quick Apply
UM Authorization Analyst 2 Bilingual
Starling Oncology —Delaware City, DE
- $71,000 - $85,000 a year
- Remote
- Spanish
- Customer service
- English
Quick Apply
3d
Orthopedic Bracing Eligibility Analyst
SYNERGY ORTHOPEDICS, LLC —Broomall, PA
- $18 - $22 an hour
- Surgery
- OSHA
- HIPAA
Quick Apply
Surgical Coordinator
American Orthopedic Partn —Mullica Hill, NJ
- $19 - $26 an hour
- Full-time
- Surgery
- Mid-level
- High school diploma or GED
Quick Apply
9d
BH Information and Referral Navigator
Chester County of Pennsylvania —Westtown, PA
- $21.14 an hour
- Extended hours
- Microsoft Word
- Microsoft Outlook
- Computer literacy

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Managed Care Coordinator (Pre-Cert)

First State Orthopaedics -
Newark, DE

Quick Apply

Job Details

Full-time
From $17 an hour

Benefits

Health savings account
Disability insurance
Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Employee assistance program
Vision insurance
Life insurance
Referral program

Qualifications

Health insurance authorizations
Health insurance verification via paper documents
Insurance verification
Health insurance information
Medical coding
High school diploma or GED
ICD-10
Health insurance pre-authorization requirements
Data entry
CPT coding
Typing
Health insurance verification via electronic systems
Medical terminology

Full Job Description

Job Title: Managed Care Coordinator (Pre-Cert)

Reports To: Pre-Cert Supervisor

Position Objective: Resolve all managed care issues by obtaining precertification and

benefit verification for appointments, procedures, surgeries and testing’s.

Position Requirements: High School Diploma. Minimum of one year medical

insurance verification experience preferred. Excellent communication and typing skills

and a working knowledge of CPT/ICD10 coding and medical terminology required.

Detailed Responsibilities:

Provide determinations on authorization request to members and/or providers

and document information in computer system.

Pre-Cert STAT testing; provide requested authorization info to facilities.
Obtains required referrals for HMO Insurances.
Works with physician first assistant to obtain necessary info to authorize

scheduled testing.

Verifies benefits for new patient office visits & make Alert in system. Enter

correct insurance information into system.

Obtains required authorizations for precertifications of surgeries & also obtains

surgical benefit information either on web or phone w/customer services reps.

Informs patient either by mail or phone of surgical benefits prior to surgery.
Gathers & informs patients of benefit information for HA injections & requests

prepay when it applies.

Assists Patient Accounts when claim is wrongfully denied for authorized

surgeries.

Review surgical schedule to make sure all surgeries have been precertified for

the following week.

Ability to interface with support departments and articulate issues and concerns.
Interact with a variety of personalities and situations that require tact, judgment,

poise and professionalism.

Maintaining patient confidentiality.
Organizational responsibilities: promoting patient rights; sharing problems

relating to patients or staff with immediate supervisor in a timely manner.

Physical/Mental Demands: High levels of mental concentration are required. Must

handle multiple tasks simultaneously and subject to interruptions. Physical effort

requires sitting for long periods of time and repetitive movements consisting of

reaching with hands and arms. Manual dexterity, visual acuity, and the ability to

speak and hear are required.

First State Orthopaedics reserves the right to revise this job description at any time.

EXPECTATIONS OF ALL EMPLOYEES

Provide exceptional service to all of our patients.
Exhibit professionalism and ethical behavior at all times.
Maintain strict confidentiality of patient information and business within the

organization’s policies.

Maintain OSHA and HIPAA regulations.
Treat everyone with respect, courtesy and friendliness.
Adhere to all policies and procedures for our organization.
Communicate recommendations on improvements of policies and procedures

to management.

Participate in committees, discussions and other team functions.
Provide additional duties as may be assigned.

NOTE: This job description is not intended to be all-inclusive. The above statements

are not to be construed as an exhaustive list of all responsibilities, skills or duties,

requirements, efforts or working conditions associated with the job. While this is

intended to be an accurate reflection of the current job, management reserves the right

to revise the job or to require that other or different tasks be performed when

circumstances change (e.g., emergencies, changes in personnel, workload, rush jobs,

or technological developments). This document does no create an employment

contract and employment is “at-will”.

Job Type: Full-time

Pay: From $17.00 per hour

Expected hours: 40 per week

Benefits:

401(k)
Dental insurance
Disability insurance
Employee assistance program
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Referral program
Vision insurance

Schedule:

Day shift
Monday to Friday
No nights
No weekends

Application Question(s):

Do you have working knowledge of CPT/ICD10 coding and medical terminology?
Do you have experience using NextGen?
Do you have experience using health insurance portals?

Education:

High school or equivalent (Required)

Ability to Commute:

Newark, DE 19702 (Required)

Work Location: In person

Quick Apply

Refine Your Search

referral specialist jobs in wilmington, de

Managed Care Coordinator (Pre-Cert)

Physician Authorization/Referral Specialist I

Insurance Verification Specialist

Preregistration Specialist

Orthopedic Authorization Liaison

Global Medicine Business Operations Coordinator

Genetics Counselor Assistant-Cardiology

Financial Counselor - Full Time Days at Pennsylvania Hospital

Medical Office Referral Coordinator

Billing Agent (Contract)

Insurance Coordinator

Insurance Verification Specialist

Technical Referrals Logistician II

Pre-Encounter Representative

Part-Time Utilization Specialist- OMY

Dental Eligibility and Insurance Coordinator

UM Authorization Analyst 2 Bilingual

Orthopedic Bracing Eligibility Analyst

Surgical Coordinator

BH Information and Referral Navigator

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