Referral Specialist - Orthopedic and Sports Care

Primary Duties

• 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.
• Responsible for communication and dissemination of 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.

Requirements

• REQUIRED for the position:
• 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

Qualifications

• DESIRED for the position:
• 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
• Flexible Spending Account
• Life and disability insurance
• Retail plans (457(b) and 401(a) with employer contribution)
• Tuition assistance for undergraduate and graduate degrees
• Retirement plans
• (Federal Public Service Loan Forgiveness program)
• Paid Time Off/Vacation
• Extended Illness Bank/Sick Leave
• Voluntary hospital indemnity insurance
• Voluntary identity theft protection
• Voluntary legal insurance
• Pay in lieu of benefits premium program
• Free parking
• Commuter benefits