Referral Specialist Alaska Facial Plastic Surgery & ENT - 4.5 Anchorage, AK Job Details Full-time From $54,080 a year 21 hours ago Benefits Health insurance 401(k) Paid time off Parental leave 401(k) matching Employee discount Qualifications HIPAA Employee relationship building Medical scheduling High school diploma or
GED ICD-10
Attention to detail Medical receptionist Full Job Description Job Overview We are seeking a dynamic and detail-oriented Referral Specialist to join AFPENT Monday - Friday, 07:45am - 04:15pm in our Anchorage practice. The Referrals Specialist is responsible for coordinating and managing the patient referral process from initiation through completion. This position ensures patients receive timely specialty care by obtaining insurance authorizations, scheduling appointments, and maintaining accurate referral documentation within the Referrals System and Electronic Health Record (EHR). The Referrals Specialist serves as a liaison between patients, providers, insurance carriers, and other clinics while delivering exceptional customer service and ensuring compliance with policies, payer requirements, and HIPAA regulations. Responsibilities Process incoming patient referrals accurately and efficiently. Verify patient insurance eligibility, benefits, and referral requirements. Submit prior authorization and precertification requests to commercial insurance carriers, Medicare, Medicaid, Tricare, VA, and other payers as required. Obtain records and supporting clinical documentation necessary for provider review. Track referral and authorization status and follow up on pending requests to ensure timely completion. Schedule appointments with providers in a timely manner. Communicate appointment information, referral instructions, insurance requirements, and estimated patient financial responsibility to patients. Educate patients regarding referral processes, insurance guidelines, and authorization requirements. Document referral activity, patient communications, insurance information, and authorization updates accurately in the Referrals System and Electronic Health Record (EHR). Coordinate with physicians, medical assistants, specialists, hospitals, and insurance representatives to resolve referral and authorization issues. Monitor referral work queues and prioritize requests based on urgency and clinical need. Maintain confidentiality of patient information in accordance with HIPAA and organizational policies. Respond promptly to telephone calls, electronic messages, and patient inquiries. Identify and communicate referral or authorization barriers to providers and leadership. Assist with departmental quality improvement initiatives and workflow efficiencies. Provide back up support for front desk during heavy clinic hours, breaks and vacations. Additional Responsibilities Maintain professional appearance and conduct at all times. Establish and maintain effective working relationships with physicians, physician assistants, staff, and management. Use professional and effective communication with patients and colleagues. Effectively manage job-related stress in a busy clinical environment. Document work processes and follow clinic policies and procedures. Qualifications Education Minimum High school diploma or GED Certification Healthcare, Coding, or other medical certifications strongly preferred Experience Preferred experience includes: One (1) year of experience in a medical office or healthcare setting required. Previous experience with referrals, insurance verification, appointment scheduling, or prior authorizations preferred. Experience using Electronic Health Records (EHR/EMR) systems preferred. Knowledge of CPT, ICD-10, and payer authorization guidelines strongly preferred. Experience working in Otolaryngology (ENT), surgical specialties, or multispecialty clinics strongly preferred. Skills and Competencies Strong communication and interpersonal skills. Ability to maintain professionalism and compassion with patients. Strong organizational and multitasking abilities. Attention to detail and accuracy in documentation. Ability to work effectively in a fast-paced clinical setting. Physical Requirements This position requires the ability to: Prolonged periods of sitting and computer work. Frequent telephone communication. Ability to occasionally stand, walk, bend, and lift up to 20 pounds. Manual dexterity sufficient to operate standard office equipment. Visual acuity necessary to review electronic medical records and documentation.
Pay:
From $54,080.00 per year
Benefits:
401(k) 401(k) matching Employee discount Health insurance Paid time off Parental leave
