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GP
Greater Portland Health
Referral Specialist
Career Insights for Eligibility Specialist
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Based on Maine data
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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.
$57,420 / year median in Maine
+17% projected growth
Job Description
The Referrals Specialist is responsible for processing, scheduling, and tracking referrals to specialists; provides patients with proper documentation of date, time, and any necessary preparations for scheduled tests and referrals. This position tracks all scheduled services through to completion and processes insurance referrals and prior authorizations for visits with specialty offices. This is a part-time position, 20-24 hours per week and is not eligible for a hybrid or fully-remote schedule. Requirements Level 3 English required. Associate degree preferred. Experience in coordination of care, case management, or medical referrals required. Knowledge of community resources. Knowledge of medical office procedures and terminology. Knowledge of basic arithmetic to make calculations, balance and reconcile figures, and make changes accurately. Knowledge of Medicare, Medicaid, managed care, HMO, band private insurers. Knowledge of CPT (procedures code) and ICD-10 codes.