Referral Specialist jobs in Racine, WI
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)
Recently Added Referral Specialist jobs
Prior Authorization/Referral Specialist
- Froedtert South, Inc.
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Kenosha, WI
FULL_TIME
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POSITION PURPOSE
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A Prior-Authorization/Referral Specialist is responsible for determining insurance eligibility/benefits and ensuring pre-certification (authorization/referral) requirements are met for both the facility and professional services. The Prior-Authorization/Referral Specialist provides detailed documentation and communication with both payors and clinicians to obtain prior-authorizations. Obtains clinical information to support medical necessity.
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MINIMUM EDUCATION REQUIRED
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High School or GED
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MINIMUM EXPERIENCE REQUIRED
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1-3 years
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LICENSES / CERTIFICATIONS REQUIRED
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Formal education beyond high school in Business or Healthcare or equivalent experience preferred.
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KNOWLEDGE, SKILLS & ABILITIES REQUIRED
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Experience in prior authorization/referrals, patient registration, insurance verification and health insurance plans.
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Knowledge on online insurance prior-authorization process and working with various payors.
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Excellent customer service and computer skills.
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Familiarity with Medical Terminology.
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Demonstrated ability to efficiently organize work, while maintaining a high level of accuracy and productivity.
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Knowledge of ICD-10, CPT and HCPC codes and use.
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Familiarity with internet, email and Microsoft Office.
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Effective written and verbal communication skills required.
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PRINCIPLE ACCOUNTABILITIES AND ESSENTIAL DUTIES
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Verifies eligibility and benefit levels to ensure adequate coverage for identified services.
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Obtains pre-certification, authorization and referral approval for required services for both the facility and professional services.
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Calculates "billable units" for medication as identified by the payer rather than utilizing patient visits.
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Manages and resolves assigned departmental workqueues.
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Coordinates and supplies information to the review organization (payer) including clinical information and/or letter of medical necessity for determination of benefits. Coordinates peer-to-peer reviews, when required.
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Communicates with patients, clinicians, financial counselors and other as necessary to facilitate the authorization process.
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Completes accurate documentation in healthcare software.
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Completes inpatient notification to all payers using their preferred method within 24 hours of admission.
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Ensures timely and accurate insurance authorizations/referrals are in place prior to services being rendered.
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Notifies patient/department when authorization/referral has not been obtained prior to service date.
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- 15 Days Ago
Clinical Referral Specialist I
- Advocate Aurora
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Racine, WI
FULL_TIME
- Major Responsibilities:Reviews work queues to identify unscheduled ordered services and connects with the patient to schedule the appropriate service.Schedules appointments including complex specialty...
- 1 Day Ago
Referral Coordinator
- Vista Health System
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Waukegan, IL
FULL_TIME
- Apply Now at Vista Health System and begin working and servicing patients in our community! Invest your time in providing quality care for the communities we serve! Vista Health System is a community ...
- 28 Days Ago
Veterinary Technician
- Wisconsin Veterinary Referral Center - Kenosha
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Racine, WI
FULL_TIME
- TAKE YOUR CAREER TO THE NEXT LEVEL! Wisconsin Veterinary Referral Center (WVRC) by Ethos Veterinary Health in Racine, Wisconsin is looking to hire a Full-time ER Veterinary Technician. Shift details =...
- 8 Days Ago
Internist in Racine/Kenosha
- Wisconsin Veterinary Referral Center - Kenosha
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Kenosha, WI
FULL_TIME
- Wisconsin Veterinary Referral Center (WVRC) [http://www.wvrc.com/] is seeking a board-certified or residency trained Internist to join our specialty hospital in Racine/Kenosha, WI. This is your opp...
- 25 Days Ago
Medical Oncologist in Racine/Kenosha WI
- Wisconsin Veterinary Referral Center - Kenosha
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Kenosha, WI
FULL_TIME
- Wisconsin Veterinary Referral Center (WVRC) [http://www.wvrc.com/] is seeking a BOARD-CERTIFIED OR RESIDENCY TRAINED MEDICAL ONCOLOGIST TO START UP AND DEVELOP THE ONCOLOGY SERVICE AT OUR SPECIALTY HO...
- 1 Month Ago
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0 Referral Specialist jobs found in Racine, WI area
Training Specialist
- Crisis Prevention Institute
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Milwaukee, WI
- Our Story: Crisis Prevention Institute Inc. is the worldwide leader in evidence-based de-escalation and crisis preventio...
- 4/18/2024 12:00:00 AM
Accounts Receivable Billing Specialist
- MRA Recruiting Services
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Oak Creek, WI
- Bliffert Lumber & Hardware Accounts Receivable Billing Specialist Onsite Role Oak Creek, WI Bliffert Lumber is on the lo...
- 4/18/2024 12:00:00 AM
Maintenance Specialist
- Manpower
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Milwaukee, WI
- Job Title: Maintenance Specialist Location: Milwaukee, WI Payrate: 25/hr What's the Job? Performs repairs of an assigned...
- 4/18/2024 12:00:00 AM
Product Expert -0024
- American Sale
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Lake Zurich, IL
- Job Description Job Description Job Opportunity: Store Associate/ Product Expert at American Sale- Bring the Fun Home! A...
- 4/17/2024 12:00:00 AM
Field Expert (Certified Licensed)
- Moxie Pest Control
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Milwaukee, WI
- Job Description Job Description Want a career change? Not sure if your current job is right for you? Moxie Pest Control ...
- 4/16/2024 12:00:00 AM
Training Specialist
- Crisis Prevention Institute
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Milwaukee, WI
- Our Story: Crisis Prevention Institute Inc. is the worldwide leader in evidence-based de-escalation and crisis preventio...
- 4/16/2024 12:00:00 AM
Document Management Specialist
- Dovenmuehle Mortgage Inc.
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Lake Zurich, IL
- Job Description Job Description Full time - Remote in US Office location: Lake Zurich, IL, Department: Document Manageme...
- 4/16/2024 12:00:00 AM
Sleep Expert - Sales
- Mattress Firm
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Waukesha, WI
- Is your current job a nightmare? Make it a dream job at Mattress Firm®! Join Mattress Firm as a Sleep Expert® and have t...
- 4/5/2024 12:00:00 AM
About Racine, Wisconsin
Racine (/rəˈsiːn/ rə-SEEN) is a city in and the county seat of Racine County, Wisconsin, United States. It is located on the shore of Lake Michigan at the mouth of the Root River. Racine is located 22 miles south of Milwaukee. As of the 2010 U.S. census, the city had a population of 78,860, making it the fifth-largest city in Wisconsin. Its median home price of $103,625 makes it one of the most affordable cities in Wisconsin to buy a home. In January 2017, it was rated "the most affordable place to live in the world" by the Demographia International Housing Affordability survey.
Racine is th...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Referral Specialist jobs
$39,367 to $48,330
Racine, Wisconsin area prices
were up 1.8% from a year ago
were up 1.8% from a year ago
What does a Referral Specialist do?
Referral Specialist in Terre Haute, IN
This position serves as the centralized intake for all internal referrals to core service programs.
December 12, 2019
Referral Specialist in Albany, NY
The Information and Referral Specialist 1 is the entry level classification which gathers information on community resources and utilizes a broad knowledge of the community resource network to make appropriate referrals to service providers.
December 01, 2019
Referral Specialist in Florence, AL
As a Referral Specialist you will execute patient insurance referrals, consultations, and diagnostic procedures relating to Kadlec Clinic.
January 14, 2020