Medical Referral Specialist
2 days ago
The Referral Specialist coordinates insurance referrals for Citizens patients, ensuring coverage meets standards of order and referral criteria. The position provides insurance verification and authorization for insured patients.
- Responsible for oversight of the insurance referral/authorization process to include timely scheduling and complete processing of eligibility and benefit verification, initial and ongoing referral/authorization requests, and accurate entry of relation information in designated software system.
- Maintain policies and procedures to ensure timely communication of referral and authorization status to multiple locations as needed, providing necessary information to facilitate decision making for patient scheduling and visit utilization coverage.
- Maintains efficient tracking of all pending referrals to ensure timely scheduling and avoid loss of revenue.
Required skills and qualifications:
- One-year medical office pre-authorization and referral experience.
- Knowledge of payer guidelines and regulatory requirements, including third-party procedures and practices required.
- Working knowledge of medical terminology, good human relations, and analytical skills required.
Benefits:
Citizens offers a generous benefit package that includes retirement plans upon hire, and an excellent medical plan with optional insurance plans to choose from.
Others:
U.S. Patents 7,080,057; 7,310,626; 7,558,767; 7,562,059; 7,472,097; 7,606,778; 8,086,558 and 8,046,251.
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