Referral Specialist - Neurosurgical Care

About the role

Responsible for the coordination and administrative requirements for patient referral from a primary care provider (PCP) to specialists or specialty services, dealing directly with health plans. Makes decisions and authorizes risk‑planning referrals, utilizing department and organizational guidelines. Requires daily interaction with patients, staff, healthcare providers and insurance companies.

Responsibilities

• Demonstrates mastery of all Patient Service Representative duties.
• Processes patient referrals from PCP to specialist, working directly with health plans, troubleshooting when necessary.
• Serves as a point person coordinating information regarding managed‑care referrals for patients, providers, case managers and other Utilization Management staff.
• Assigns proper ICD‑10 and CPT code(s) to patient referrals.
• Communicates and disseminates key managed‑care contractual information and system processes to patients and staff.
• Identifies and communicates changes in insurance requirements, provider changes and guidelines to leaders and team members.
• Performs other duties as assigned.

Requirements

Required:

• Associate degree or equivalent combination of education and experience.
• 3 years of experience in a healthcare insurance or related medical office setting.
• Working knowledge of ICD‑10 and CPT codes.
• Ability to be flexible and relate well with others in a professional and pleasant manner.
• Knowledge of medical records confidentiality.
• Excellent communication skills with a high degree of tact and poise to deal effectively with patients, physicians, and hospital staff members.

Desired:

• Medical Terminology, medical billing, and computer skills.
• Working knowledge of insurances, Medicare, DSHS, Labor and Industries, and other third‑party insurances.

Benefits

• Medical, vision, and dental insurance
• On‑demand virtual health care
• Health Savings Account (HSA)
• Flexible Spending Account (FSA)
• Life and disability insurance
• Retirement plans (457(b) and 401(a) with employer contribution)
• Tuition assistance for undergraduate and graduate degrees
• Federal Public Service Loan Forgiveness program
• Paid Time Off/Vacation
• Extended Illness Bank/Sick Leave
• Paid holidays
• Voluntary hospital indemnity insurance
• Voluntary identity theft protection
• Voluntary legal insurance
• Pay in lieu of benefits premium program
• Free parking
• Commuter benefits

Pay

Wage range: $23.72 – $37.95 per hour. Posted wage ranges represent the entire range from minimum to maximum. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. Some positions also offer additional premiums based on shift, certifications, or degrees. Job offers are determined based on a candidate's years of relevant experience, level of education, and internal equity.