Referral Specialist processes insurance pre-verification for hospital admissions or specialty service office visits. Gathers pertinent information from patients, insurance carriers, financial counselors, and other staff to confirm the patient's financial obligations for services. Being a Referral Specialist acts as a liaison between hospitals, clinical staff, health plans, providers, and patients to process referrals. Verifies insurance coverage and obtains required authorizations when necessary. Additionally, Referral Specialist documents referrals, communications, actions, and other data in an information management system. Generates and distributes all applicable forms, notifications, and paperwork. Requires a high school diploma. Typically reports to a supervisor. The Referral Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Referral Specialist typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
Description
SUMMARY: Coordinates the AxessPointe Community Health Center, Inc. (API) patient referral process for specialty care as determined by the clinic’s medical providers, maintaining an established system of patient tracking and reporting.
SUPERVISOR: Health Center Administrator
DUTIES AND RESPONSIBILITIES:
Note: This job description is not intended to be an exhaustive list of all duties, responsibilities or qualifications associated with this job.
Requirements
MINIMUM QUALIFICATIONS:
LICENSES OR CERTIFICATIONS REQUIRED:
COMPLIANCE:
This position requires compliance with API's written standards, including its Compliance Program and Standards of Conduct and policies and procedures. Such compliance will be an element considered as part of the regular performance evaluation.
Failure to comply with API's Written Standards, which may include the failure to report any conduct or event that potentially violates legal or compliance requirements or API's Written Standards or, for managers and supervisors, fails to detect non-compliant conduct where reasonable efforts would have resulted in detection, will be met by the enforcement of disciplinary action, up to and including possible termination, in accordance with API's Compliance Program Policy and Procedure: Addressing Instances of Non-Compliance through Appropriate Disciplinary Actions.
PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit, and use hands to finger handle or feel; to talk; or hear. The employee is frequently required to reach with hands and arms. The employee must occasionally stand, walk, climb or balance, stoop, kneel, crouch or crawl. The employee must be able to frequently lift up to 25 pounds. The employee may occasionally be required to lift 25 to 50 pounds; however, this is not essential; duties may be shifted to accommodate lifting restrictions.
WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is frequently required to use close vision (clear vision at 20 inches or less). The employee will occasionally be working near moving mechanical parts, be exposed to outdoor weather conditions and exposed to a risk of electrical shock while running the copier, printer, other standard equipment and answering the telephone. The noise level in the work environment is low to moderate. Stress level can be high at times.
Note: This job description is not intended to be an exhaustive list of all duties, responsibilities or qualifications associated with the job.
0 Referral Specialist jobs found in Akron, OH area