REFERRAL SPECIALIST-PPO

About the Role

LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to "improve the health of people in the communities we serve." Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care.

Responsibilities

• Prepares and initiates referrals, obtains and tracks authorizations, and follows up on outstanding referrals.
• Verifies patient coverage for specific benefits.
• Answers incoming calls regarding referrals.
• Completes referrals initiated by the primary care physician in a timely and accurate manner; encloses any pertinent information from the patient's chart and contacts patient when referral is complete.
• Obtains authorizations for scheduled procedures and admissions; assures compliance; coordinates with managed care payors.
• Maintains, prioritizes and monitors work flow to ensure authorizations and referrals are completed in a timely and accurate manner.
• Tracks and ages referrals; follows up on those outstanding with the appropriate person.
• Completes and submits accurate monthly statistic reports.
• Provides specialist information to the patient to allow them to make their own appointment according to their availability.

Qualifications

• Preferred Associate's Degree or equivalent
• 1-3 years required

Skills

• Scheduling experience
• Prior Authorization experience
• Medical terminology