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Form of work
SalaryRequired Education and Experience: High School Graduate or equivalent (GED and 4 years of related experience may be equivalent).
Preferred Education and Experience:One to two years referral experience preferred or basic working knowledge of referrals.
Additional Eligibility Qualifications: Knowledge of insurance plan referral requirements and referral processes. Ability to demonstrate excellent communication skills (oral and written). Ability to retain detailed information to perform daily duties and assist physician offices with proper referral processing. Ability to type 35wpm and have basic knowledge of IDX scheduling. Ability to multi-task in a fast paced environment and possess excellent organizational skills. Advanced telephone skills as a primary instrument of communication.
Summary/Objective: Responsible for ensuring that a patient's insurance allows them to access the services of the specialist's health care provider.
Essential Functions
Access information through the use of the billing system and the 3-day out report
Coordinates the pre-certification process between the physician’s office and the insurance carrier.
Adds referral information into computer system as received from the insurance carrier
Maintains good communication with the physician offices and support staff to ensure efficient handling of referrals
Maintains resources and documents inquiry and actions taken in the Referral Comments
Addresses patient and health plan issues/concerns effectively
Adheres to department and Clinic policies and procedures
Attends departmental meetings to keep informed of departmental issues and policies
