Referral & Insurance Specialist — Upstate Cardiology

About Us

Bon Secours exists to enhance the health and well-being of all people in mind, body, and spirit through exceptional patient care. Success in this goal requires a culture of compassion, collaboration, excellence, and respect. Bon Secours seeks people committed to our values of compassion, human dignity, integrity, service, and stewardship to create an environment where associates want to work and help communities thrive.

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.
• Collections 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.
• Aids in 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.

Qualifications

• High School Diploma or GED (required)
• 2-3 years of experience in a related medical field with experience in processing referrals (preferred)

Benefits

Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources and discounts
Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
Tuition assistance, professional development and continuing education support

Pay

Details about pay will be provided during the interview process.

Schedule

Details about the schedule will be provided during the interview process.