Referral Representative

About the role

Working under the direction of the Referrals Supervisor, this position is responsible for providing a variety of support services essential to the efficient operation of the organization’s referral process. Works closely with clinical department staff and customer service staff in the offices. 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.

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 per protocols and provide feedback to 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 by offering guidance and support for referral-related questions, processes, and problems
• Perform other duties as assigned by Manager and Supervisor

Qualifications

• High school diploma or equivalent
• Minimum of three (3) years’ experience in healthcare preferred
• Experience within a medical office or billing department preferred
• Medical terminology preferred
• Knowledge of patient billing preferred

Skills

• Proficiency with all Microsoft products (Word, Excel, PowerPoint, Outlook) required
• EPIC experience preferred
• Excellent organizational skills and ability to multi-task
• Excellent oral and written communication skills
• Ability to evaluate and manage multiple priorities and demonstrate follow-through

Benefits

• Great benefits effective day 1
• Growth opportunities
• Inclusive culture

Schedule

40 hours, Day shift