Referral Management Specialist

Are you seeking a career with a growing company, a place where you can make an impact in the community? Then Positive Impact Health Centers is the company for you.
Positive Impact Health Centers (PIHC) is a community leader in providing HIV prevention, care and treatment services located in Metro Atlanta. The PIHC model of care assures that clients have access to medical, pharmacy, dental, behavioral health and social services, providing the best opportunity for patients to achieve high-quality health outcomes. Services are provided on-site and through telehealth.
What makes us different? We offer our employees the following:
• 1 Health Wellness day per quarter
• Parental Leave
• Free parking at our locations/bus line accessibility
• Competitive Salary & Benefits
• Automatic 3% Safe Harbor & 2% Profit Sharing (Retirement Program)
• 100% allotted for benefit elections for employees, 50% allotted for benefit elections for employee's spouse/dependent
• Credit Union
*Proof of Covid-19 vaccination is required*
JOB SUMMARY: The Referral Management Specialist manages the administrative and financial management duties related to the interactions of PIHC patients with external specialty providers. This position consists of maintaining positive working relationships with specialty partners and effectively communicating financial matters on the behalf of PIHC patients and the agency overall.
Requirements
General Duties

• Perform the following tasks as it relates to specialty care Invoices:

1. Matching invoices to correct referrals, ensuring patient does not have insurance and adjust the total invoice according to Medicare rates.
2. If patient has insurance, inform vendor to rebill patient's insurance. Process invoices for various specialty offices. Research missing invoice payments through Abila.
3. Scan all referrals into patient chart, adjust invoices to Medicare rates, match invoices to the correct referrals and submit to Director for approval, scan completed invoices to AP for payment.

• Perform the following tasks as it relates to dental referrals and invoices:

1. Matching invoices to correct dental referrals, ensuring patient does not have insurance, add referral number and fax referral to dentist, scan referrals into EMR with treatment plan into patient EMR chart.
2. Review monthly aging reports and compare to AP vendor information in Abila.
3. Request missing invoices to process.

• Reply to Specialty Care vendors, Dental vendors and Patients to research missing or unpaid invoices by contacting vendors through email, faxing and telephone calls.
• Research for missing invoices, payments through Abila system.
• Maintain accuracy of patient demographic and insurance information by verifying this information at each patient encounter.
• Protects patients' rights by maintaining confidentiality per HIPPA guidelines.
• Maintain relative spreadsheets that track payments to associated specialists for reporting
• Perform other job-related duties as assigned.

Knowledge, Skills & Abilities
• Experienced in working with indigent and culturally diverse populations
• Knowledge of basic medical office billing and insurance knowledge. Medicaid/Medicare knowledge a plus.
• Knowledge of Medical Terminologies
• Must have great communication skills, (writing, spelling, listening and speaking)
• and interpersonal skills
• Must have strong computer and EMR skills, and have a positive, friendly and helpful demeanor.
• Must have excellent customer service skills and warm personality.
• Must have ability to work in a fast-paced environment and paying attention to detail.
• Ability to maintain high level of confidentiality and have empathy for our clients
• Ability to follows through to completion of assigned tasks
• Ability to multi-task, be detail oriented, be patient focused,
• Ability to maintain a professional appearance,
• Ability to work as a team member
• Ability to resolve problems
• Ability to work without close supervision
Education and Experience
Associate Degree and Minimum of two years experience needed in a medical Front Office environment, including basic medical billing experience
Salary Description
$22.00