Referral Specialist jobs in Fort Worth, TX

Typical Duties:

1. Coordinates with medical staff, payers, physicians, and patients regarding authorization status and options.


2. Maintains current referral procedures according to payer requirements.


3. Oversees inbound, outbound calls and/or review correspondence, documents and other referrals received via fax or email.


4. Initiate, follow up, and verify insurance eligibility and benefits for services ordered and document complete information in Epic referral notes.


5. Obtains prior authorizations as required by payer, including procurement of needed clinical documentation by collaborating with Clinical Care Team and payer. Obtain all authorizations via web, fax or phone.


6. Assist patient with finding resources that accept various insurances, when processing Outgoing/External referrals.


7. Determines patient’s financial responsibilities as indicated by payer.


8. Configures coordination of benefit information and eligibility on every referral.


9. Documents all pertinent communication with patient, physician, and payer.


10. Reviews and manages Epic work queues to maintain accurate and timely authorization requests.


11. Schedules appointments as appropriate within required timeframes.


12. Serves as a resource liaison with referral/appointment inquiries from patients, clinical care teams, and other staff.


13. Meets productivity and documentation standards while following planned priorities as set by Patient Access Team Lead and/or Manager.


14. Performs other related job duties as assigned.