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)
UnityPoint Health
Referral Specialist
West Des Moines, IA
1.0 FTR (40 hours/week) Full time benefits
Monday through Friday 8:30-5pm
Manage all facets of the patient referral process. The scope of the referral process begins with receipt from the provider through to the communication with the patient. Responsibilities include, but are not limited to, obtaining pre-certification or prior-authorizations, scheduling the visit with specialist or outpatient services, completion of documentation with the electronic medical record (EMR) and communicating referral information to referring offices and to the patient.
Why UnityPoint Health?
Visit us at UnityPoint.org/careers to hear more from our team members about why UnityPoint Health is a great place to work. https://dayinthelife.unitypoint.org/
Coordination of Patient Appointments & Authorizations
Correspondence with Patients
Obtain Pre-Certifications and Prior Authorizations
Education: High School diploma or equivalent. Graduate of accredited medical assistant, CNA and/or nursing program, preferred.
Experience: 2-3 years previous experience in medical field. Basic knowledge of medical terminology, anatomy and physiology. Experience with insurance verification/pre-authorizations, Basic knowledge of Current Procedural Terminology (CPT) and International Classification of Disease (ICD-10) coding, is preferred.
Knowledge/Skills/Abilities:
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