Referral Specialist -

Overview We are seeking a dedicated and detail-oriented Referral Specialist to join our healthcare team. The ideal candidate will possess a strong understanding of managed care processes, medical office operations, and insurance protocols. This role offers an opportunity to facilitate seamless patient referrals, coordinate with healthcare providers, and ensure compliance with privacy regulations such as HIPAA. The Referral Specialist will play a vital role in optimizing patient care pathways through effective communication and meticulous record management. Duties including but not limited to the following: Coordinate patient referrals between healthcare providers, specialists, and insurance companies, durable medical equipment to ensure timely and accurate processing, re-type (letters and reports) pulling charts, dealing with customer service, extensive time on the phone and with insurance companies, documentation must be handled to ensure timely medical care. Verify insurance coverage and benefits, including insurance verification procedures, pre-authorizatuon to facilitate smooth referral approvals. You will be the liaison between primary care providers, specialists, and patients securing approvals, transmitting medical records and tracking referrals to ensure timely medical care. Maintain comprehensive medical records, ensuring accuracy and confidentiality in accordance with HIPAA regulations. Utilize medical coding systems such as CPT (Current Procedural Terminology), ICD-9 (International Classification of Diseases, Ninth Revision), ICD-10 (Tenth Revision), and ICD coding to accurately document diagnoses and procedures. Review and process referral documentation, ensuring compliance with managed care policies and office protocols. Collaborate with medical offices, insurance companies, specialist, medical to streamline referral workflows and improve patient experience. Stay updated on industry standards related to managed care, medical terminology, and insurance requirements to provide expert support. Qualifications Prior experience working in a medical office is highly preferred. Knowledge of managed care systems, insurance verification processes, and medical coding (CPT, ICD-9, ICD-10). Familiarity with HIPAA regulations concerning patient privacy and data security. Strong organizational skills with the ability to manage multiple tasks efficiently in a fast-paced setting. Excellent communication skills for effective interaction with healthcare providers, patients, and insurance representatives. Experience with medical records management and familiarity with medical terminology is essential. Office experience combined with knowledge of medical billing or coding is advantageous. Join our team as a Referral Specialist to contribute to efficient healthcare delivery by ensuring accurate referrals, maintaining compliance standards, and supporting exceptional patient care through meticulous record management and communication.

Pay:

$18.00 - $22.00 per hour

Benefits:

Employee discount Health insurance Paid time off Application Question(s): Are you willing to work with paper charts with a clip system as well as computer knowledge

Education:

High school or equivalent (Required)

Experience:

referral: 1 year (Required) Ability to

Commute:

New Caney, TX 77357 (Required)

Work Location:

In person