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)
SHIFT: Full-Time Days, No Holiday or Weekends
POSITION TO BE FILLED: As Soon as Possible
JOB SUMMARY:
We are looking for a hardworking, team-focused individual with who takes pride in their organization! The Referral/Authorization Specialist completes authorizations and referrals for services, including appointments, procedures, surgeries, etc. Multitasking skills and self-motivation required. Position is in St. Maries Family Medicine Clinic, also working with the BCH Specialty Clinic.
QUALIFICATIONS:
1. Medical knowledge required.
2.Licensure/Experience: Prior-authorization, insurance, or Coding experience, with at least 1-years’ experience in a clinical setting (Clinically licensed OR non-licensed)
3. Licensed, Clinical staff maintains BLS certification
EOE/M/F/V/D