Job Summary We are seeking a dedicated and detail-oriented Referral Specialist to join our dynamic healthcare team. In this vital role, you will serve as the primary point of contact for coordinating patient referrals, ensuring seamless communication between providers, insurance companies, and patients. Your expertise will help facilitate timely access to specialized care while maintaining strict adherence to healthcare regulations and confidentiality policies. If you thrive in a fast-paced environment and are passionate about improving patient experiences through efficient referral processes, this opportunity is perfect for you! Duties Manage and process patient referrals by verifying insurance coverage, obtaining prior authorizations, and ensuring all documentation complies with healthcare policies. Collaborate with healthcare providers to gather necessary clinical information and ensure accurate referral details. Utilize Electronic Medical Records (EMR) and Electronic Health Records (EHR) systems to document referral activities thoroughly and accurately. Verify insurance eligibility, benefits, and coverage limits using health insurance policies and managed care guidelines. Communicate proactively with patients, providers, and insurance companies to resolve issues related to referrals, authorizations, or coverage denials. Maintain strict confidentiality of medical records and adhere to HIPAA (Health Insurance Portability and Accountability Act) regulations at all times. Stay updated on medical coding standards including CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding to ensure accurate documentation for billing and reimbursement purposes. Skills Strong knowledge of HIPAA regulations and clinical confidentiality policies to protect patient information. Proficiency in medical terminology, medical records management, and medical coding including

CPT, ICD-9, ICD-10

codes. Experience with EMR/EHR systems and Microsoft Office applications for documentation and communication. In-depth understanding of health insurance policies, managed care processes, insurance verification, and prior authorization procedures. Excellent customer service skills with the ability to communicate clearly and professionally with diverse stakeholders. Knowledge of medical billing processes related to referrals and insurance claims processing. Ability to multitask efficiently in a fast-paced environment while maintaining attention to detail. Join us in making a meaningful difference by streamlining the referral process! We are committed to supporting your professional growth with comprehensive training opportunities and a collaborative work environment that values your contributions.

Pay:

$18.00 - $21.00 per hour

Benefits:

Dental insurance Health insurance Paid time off Vision insurance

Language:

English (Required)

Work Location:

In person