Referral Representative

About the Role

Working under the direction of the Referrals Supervisor, this full-time, day-shift position provides a variety of support services essential to the efficient operation of the organization’s referral process. You will work closely with clinical department staff and customer service teams in the offices.

Responsibilities

• Process and maintain the electronic Epic Referrals Workqueue, prescreening for completeness of information, urgency, and other designated criteria.
• Complete pre-authorization workflows as required.
• Contact insurance companies to ensure prior approval requirements are met.
• Review and update patient registration for membership eligibility and PCP selection.
• Enter referrals into the system per Trinity Health Of NE MGPS protocols and provide feedback to the ordering provider as needed.
• Inform maintenance analyst/resource library of payer, benefit-specific information, and provider contact information updates.
• Answer incoming phone calls to assist internal and external customers with referral-related questions, processes, and problems.
• Perform other duties as assigned by the Manager and Supervisor.

Requirements

• High school diploma or equivalent.
• Minimum of three (3) years’ experience in healthcare preferred.
• Experience within a medical office or billing department preferred.
• Knowledge of medical terminology and patient billing preferred.
• Proficiency with Microsoft products (Word, Excel, PowerPoint, and Outlook) required.
• EPIC experience preferred.
• Excellent organizational skills and ability to multitask.
• Strong oral and written communication skills.
• Ability to evaluate and manage multiple priorities while demonstrating follow-through.

Benefits

• Great benefits effective day 1.
• Competitive pay.
• Growth opportunities.
• Inclusive culture.

Schedule

40 hours per week, day shift.

About Us

We are a group of primary care providers, specialists, and surgeons serving patients in Connecticut and western Massachusetts. Part of Trinity Health Of New England, we offer primary care, specialty care, surgery, urgent care, rehabilitation, and imaging and lab services for thousands of patients every year.