Referral Specialist jobs in South Carolina
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
- Prisma Health
-
Columbia, SC
FULL_TIME
-
Inspire health. Serve with compassion. Be the difference.
Job Summary
To provide our patients a seamless entry in to the Prisma Health experience. The Referral Specialist interfaces with patients and physician office team members to accurately authorize various consultations, procedures and tests. The Referral Specialist utilizes each patient’s preferred method of contact. The Referral Specialist utilizes various electronic medical records to transmit required clinical documentation to third party payors and Specialist Physicians. Responsibilities include documenting all actions and encounters regarding the referral including timely follow up with the patient, referring and referral physician practice and third party payors including pre-certification, cancelled and rescheduled appointments, and other events preventing closure of the referral experience.Accountabilities
- Responsible for the authorization/precertification process to include coordinating with outside and internal organizations along with insurance companies to ensure prior approval requirements are met. Presents necessary medical information such as history, diagnosis and prognosis. Provides specific medical information to financial services to maximize reimbursement to the hospital and physicians.
- Accurately records demographic, coverage, and scheduling information in various systems. Reminds patients of scheduled appointments via mail, internet, or telephone. Ensures that patient’s primary care chart is up to date with scheduling information about specialist consults, tests, and procedures managed. Alerts management to trends in appointment availability and appointment date timeliness.
- Promotes hospital goals towards meaningful use in the electronic medical record on behalf of the referring physician. Documents referral status and all scheduled appointments in appropriate system (electronic medical record) for referral tracking data. Responsible for following up after patient’s consultation, procedure, and/or test to determine if physician has received report; continues to check on status until complete.
- Serves as Liaison between the provider, practice, patient and specialist providing the service. Communicates Provides appropriate patient clinical information and referral needs to specialist office.
- Verifies physician’s orders to ensure the accuracy of results and communicates with the patient the guidelines, protocols and location.
- Assists patients in problem solving potential issues related to navigating the health care system, financial obligations or social barriers (e.g., request interpreters if appropriate, transportation services or prescription assistance). May assume advocate role on the patient’s behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion.
- Promptly responds to patient’s scheduling requirements (date and time), questions and concerns to ensure patient experience expectations are met or exceeded. Ensures timely appointments are booked; reviews details and expectations about the referral process with patients.
- Maintains patient confidentiality; complies with HIPAA and compliance guidelines established by Prisma Health.
- To ensure the effective and efficient operation of the facility and to create an extraordinary patient, physician and team member experience.
- Performs other duties as assigned.
Supervisory/Management ResponsibilitiesThis is a non-management job that will report to a supervisor, manager, director or executive.Minimum EducationHigh School diploma or equivalent; OR post high school diplomaMinimum ExperienceTwo (2) years of comparable experience, preferably in a physician front office to include patient registration and/or electronic scheduling and the authorization/precertification process.
Other Required Experience
Must have excellent customer service skills and a sincere desire to make every patient and their family feel safe, welcomed and appreciated. Excellent oral and written communication skills and interpersonal phone skills. Knowledge of various health insurance companies. Knowledge of medical terminology, CPT and Diagnosis Coding, insurance verification and updates, and the authorization/precertification process. Knowledge of Microsoft office products. Must pass data entry test 85 kst. with 90% accuracy.
Work Shift
Day (United States of America)Location
8 Medical Park Rd RichlandFacility
3185 Cardiology 8 Med Park 300Department
31851000 Cardiology 8 Med Park 300-Practice OperationsShare your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
- Just Posted
- 270 Prisma Health Medical Group-Midlands
-
Columbia, SC
FULL_TIME
- Inspire health. Serve with compassion. Be the difference. Job Summary To provide our patients a seamless entry in to the Prisma Health experience. The Referral Specialist interfaces with patients and ...
- 1 Month Ago
- Universal Health Services, Inc.
-
Aiken, SC
FULL_TIME
- Responsibilities ABOUT AIKEN PHYSICIANS ALLIANCEAiken Physicians Alliance is affiliated with Aiken Regional Medical Centers, a 273-bed acute care facility offering a comprehensive range of specialties...
- 18 Days Ago
- MUSC
-
Lugoff, SC
FULL_TIME
- Job Description SummaryMUSC Community Physicians (MCP) is an entity within the Medical University of South Carolina that provides healthcare to patients within the rural health network throughout the ...
- 6 Days Ago
- Midlands Orthopaedics and Neurosurgery
-
Columbia, SC
PART_TIME
- Midlands Orthopaedics and Neurosurgery seeks a Part-time Referral Specialist to receive and schedule incoming referrals from other physician offices via computerized appointment scheduling program and...
- 26 Days Ago
- MUSC
-
Lancaster, SC
FULL_TIME
- Job Description Summary Obtains and processes signed physician orders/referrals to ensure accurate clinical documentation for care delivery, specialty and outpatient ancillary referrals. In addition, ...
- 1 Month Ago
Referral Specialist jobs at Popular Companies
- State Farm
-
Schertz, TX
- Job Description Job Description Outbound calling generating leads/appointments/sales by phone. 4-hour shift Monday-Frida...
- 4/23/2024 12:00:00 AM
- Trinity Health
-
Des Moines, IA
- Employment Type: Full timeShift: Description: Gather, verify, and process referrals, authorizations, and pre-certificati...
- 4/22/2024 12:00:00 AM
- The South Bend Clinic
-
South Bend, IN
- Overview: Department: Business Office Location: University Commons Campus; 6301 University Commons, South Bend, IN 46635...
- 4/21/2024 12:00:00 AM
- Universal Health Services
-
Las Vegas, NV
- Responsibilities ABOUT VALLEY HEALTH PHYSICIAN ALLIANCE Las Vegas is known internationally as a major resort city often ...
- 4/21/2024 12:00:00 AM
- Matthew Walker Comprehensive Health Center
-
Nashville, TN
- Job Description Job Description Matthew Walker Comprehensive Health Center has an exciting opportunity available for a s...
- 4/21/2024 12:00:00 AM
- Elevance Health
-
Columbus, GA
- WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which ma...
- 4/20/2024 12:00:00 AM
- Elevance Health
-
Hollywood, FL
- WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which ma...
- 4/20/2024 12:00:00 AM
- Elevance Health
-
Fort Lauderdale, FL
- WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which ma...
- 4/20/2024 12:00:00 AM