Referral Specialist

Essential Functions And Job Responsibilities

• Greets and welcomes patients and guests in person and/or on the phone in a professional, respectful, and confidential manner.
• OBTAINS AND PROCESSES INSURANCE REFERRALS OR PRE-AUTHORIZATIONS BASED ON PATIENT’S INSURANCE PLAN IN A TIMELY AND ACCURATE MANNER.
• VERIFIES PATIENT’S INSURANCE COVERAGE FOR RE-CERTIFICATION, REFERRALS, AND/OR AUTHORIZATION AND UTILIZES COMPUTER SYSTEM ACCURATELY AND EFFICIENTLY TO DOCUMENT CONFIRMATION.
• OBTAINS ANY AND ALL PERTINENT HEALTH INFORMATION TO PROCESS REFERRALS AND PRE-AUTHORIZATIONS.
• SEES AND MAINTAINS CURRENT AND UP TO DATE INFORMATION REGARDING CPT & ICD-9 CODING AND INSURANCE REQUIREMENTS.
• COMMUNICATES EFFECTIVELY WITH PATIENTS, STAFF, PHYSICIANS, AND OTHER SERVE AREAS, WITH PROFESSIONALISM APPROPRIATE FOLLOW THROUGH, UTILIZING TELEPHONE, COMPUTER, AND FAX.
• OWNS DEPARTMENT CONDITIONS AND ACTIVITIES TAKING APPROPRIATE ACTION TO DELIVER A POSITIVE PATIENT EXPERIENCE.
• EXHIBITS COMPUTER SYSTEMS KNOWLEDGE AND PROFICIENCY AS NECESSARY TO PERFORM JOB FUNCTIONS.
• TAKES INITIATIVE TO SEEK OUT TASKS AND DUTIES OR TO ASSIST OTHERS AS NECESSARY.
• PERFORMS OTHER DUTIES AS ASSIGNED WHEN APPROPRIATE.
• ADHERES TO HIPAA GUIDELINES SET FORTH IN CLINIC POLICIES AND PRACTICES.