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Jefferson Hospital

Referral Specialist (PHG Wrens)

Career Insights for Eligibility Specialist

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What they do

An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.

$45,932 / year median in Georgia

+18% projected growth

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Job Description

Full-Time Referral Specialist About the
Company:
Jefferson Hospital services are provided for both inpatients and outpatients and the scope of service is consistent with the current mission of the hospital to provide quality community-based primary health care to Jefferson and surrounding counties.
Job Description:
The Physicians' Health Group Referral Specialist is responsible for facilitating and coordinating patient referrals, ensuring timely access to specialist services, and obtaining proper authorization for procedures.
Essential Duties/Responsibilities:
Answer phone calls, schedule appointments, and handle patient inquiries Maintain and update patient records, ensuring confidentiality and accuracy Obtains, verifies, and processes referrals for patients needing to see specialists or receive certain procedures. Obtains necessary authorizations and pre-certifications from insurance companies for procedures. Ensures timely reimbursement. Verifies patient eligibility and benefits with insurance companies to ensure proper coverage.
Position Requirements:
High school diploma or equivalent At least one year of experience in a medical office setting is required.
Top benefits:
As a team member at Jefferson Hospital, you'll enjoy: Comprehensive Benefits Package Health, vision, dental Paid Time Off Growth, Development, and Advancement Opportunities