Overview We are seeking a dedicated, experienced and detail-oriented Referral Specialist to join our healthcare team. The ideal candidate will possess a strong understanding of medical referral processes, insurance protocols, and healthcare documentation. As a Referral Specialist, you will play a vital role in coordinating patient referrals, verifying insurance coverage, and ensuring seamless communication between providers and patients. Your expertise in medical coding, health insurance policies, and electronic health records will contribute to delivering exceptional patient care and operational efficiency. Duties Coordinate patient referrals by communicating with healthcare providers, specialists, and insurance companies to facilitate timely appointments. Verify insurance coverage and obtain prior authorization for services using knowledge of managed care policies and insurance requirements. Maintain accurate medical records and documentation in electronic health records (EHR) systems, ensuring compliance with clinical confidentiality policies. Utilize medical coding skills, including CPT, ICD-9, ICD-10, and ICD coding standards, to ensure proper billing and reimbursement processes. Assist patients with understanding their health insurance policies and coverage options through excellent customer service. Collaborate with medical office staff to ensure all referral-related documentation is complete and compliant with HIPAA regulations. Manage insurance verification processes efficiently using Microsoft Office tools and specialized healthcare management software. Stay informed about updates in health insurance policies, clinical confidentiality policies, and medical billing regulations to maintain compliance. Requirements Proven experience in a medical office setting or healthcare environment with familiarity in medical records management. Strong knowledge of HIPAA regulations, clinical confidentiality policies, and health insurance policies. Proficiency in medical terminology, medical coding (CPT, ICD-9, ICD-10), and electronic health record (EHR) management systems. Experience with insurance verification, prior authorization procedures, and managed care protocols. Excellent customer service skills with the ability to communicate complex information clearly and professionally. Competency in Microsoft Office applications for documentation and reporting purposes. Knowledge of medical billing procedures, including coding accuracy for reimbursement purposes. Ability to multitask effectively in a fast-paced healthcare environment while maintaining attention to detail. Join our team as a Referral Specialist to ensure smooth coordination of patient care through precise referral management, comprehensive insurance processing, and exceptional service delivery!

Expected hours:

40.0 per week

Benefits:

Employee discount Health insurance Paid time off

Work Location:

In person