Referral and Insurance Specialist - Orthopedic Specialists of Midlothian

Job Summary

The Referral and Insurance Specialist obtains authorizations from insurance companies for referrals to physicians and/or procedures/testing. Verifies eligibility/coverage for referral via phone/fax/Internet. Schedules appointments for testing at medical facilities or appointments with physicians. Gathers charge information and enter all pertinent charge and patient demographic information into computer billing system. Post all payments and make daily deposits. Assist patients regarding billing questions and account balance resolution. Promotes a positive and helpful climate for good interpersonal and interdepartmental relationships.

Essential Functions

• Obtains authorizations from insurance companies for referrals to physicians/medical facilities and/or procedures/testing.
• Schedules appointments for testing at medical facilities or appointments with physicians.
• Verifies eligibility/coverage for referral/testing via phone/fax/Internet.
• Investigates billing problems and denials.
• Notifies patients of referral process whether authorized or denied in a timely manner.
• Give patients instructions.
• Performs data input of patient and/or insurance changes and corrections to ensure current and accurate information in billing system.
• Answers the telephone, take messages, schedule appointments and greet patients as needed.
• Prepares patient charge encounter forms for each day and makes new or updates patient chart as needed.
• Oversees waiting area, coordinate patient movement, and reports problems or irregularities.
• Screens visitors and respond to routine request for information.
• Organizes and files progress notes, testing reports, and other forms necessary for chart completion.
• Aids in appropriate filing of patient charts as needed.
• Collects patient responsibility balances and copayments as needed. Balance money collected daily.
• Obtains authorizations from insurance carriers or pharmacy benefit managers for medications.
• Collections all daily charge slips from the physician and reconciles the number of charge slips and their totals.
• Applies all payments to the appropriate patient account by posting each into the computer billing systems.
• Assists with coding and error resolution as well as requesting needed information by working with the physician offices.
• Assists with resolving billing questions and patient account resolution.
• As applicable, reviews information to make determination on the appropriate course of action for the patient, makes referrals to the local DSS office as appropriate.

Education

High School Diploma or GED (required)

Experience

2-3 years of experience in a related medical field with experience in processing referrals (preferred)

Pay

Range: Minimum: $18.11 Maximum: $27.17