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)
Referral specialists are responsible for ensuring patients are already cleared for specialty service office visits.
They resolve registration, pre-certification, and case-related affairs before the client's appointment.
Also, they give support to clinical staff to manage the administrative components of clinical referrals for many services.
They must gather relevant information from financial counselors, insurance carriers, and other supplementary staff to make sure the patient's financial responsibility for services are provided.
Additionally, they act as a liaison between the patients, physicians, hospitals, health insurance vendors, or other referral sources.
Last updated : 2024-04-07
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