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)
At PQC, our employees are our best asset. We pride ourselves on growth and exceeding expectations, not only for our customers but also for our employees. We believe that having the best of the best on staff translates into having the best of the best in customer results. PQC was awarded 2018 8(a) Graduate of the year by the Small Business Administration.
PQC is seeking a dedicated and experienced Referral Clerk to work onsite at Hill AFB.
Duty hours will be Monday- Friday, 20-25 hours a week
Members of our team Enjoy:
Background:
The Air Force Medical Service provides medical services for more than 2.63 million active-duty Service Members, Veterans and eligible beneficiaries. When specialty care is referred, the Referral Management Center is responsible for assisting the member, coordinating the referral with the specialty office, tracking the referral to closure, and returning all results of treatment to the patient’s medical record. The successful candidate for this position will assist members and medical professionals throughout the referral process.
Duties:
Qualifications:
PQC is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. In addition to federal law requirements, PQC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
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