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)
Responsibilities:
Assists with all clerical and administrative aspects of mammography workflow including but not limited to: Assists with Rad/Path input, Assists with written/verbal timely communication, Assist with Birads letters mailing, follow up, Assists with ensuring all exams are resulted timely or followed up accordingly, Ensures STAT/priority reports are transcribed timely, Assists with needed addendum tracking, Performs importing of all outside imaging, managing the schedule to ensure appropriate outside imaging is received timely to ensure timely release of results, Mails/faxes all reports and letters to referring physicians and patients, in accordance with FDA/MQSA guidelines, Provides department support with Epic workflow, Performances QA for reports and Birads letters tracking, Tracks patients due/past due for follow up, proactively coordinates with scheduling, Serves as relief for front desk and scheduling, Supports workflow with appropriate engagement in WQs related to reports, billing, scheduling, etc., Works closely with Breast Center management team, advising of any problems encountered with reports, billing, etc and offers suggestions for improvement
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