Referral Specialist - Topsham Family Medicine

About the role

The Department of Topsham Family Medicine at Central Maine Medical Center (CMMC) is seeking a dedicated Referral Specialist to join our team. CMMC is part of Central Maine Healthcare (CMH), a comprehensive healthcare delivery system serving over 400,000 residents in central, western, and midcoast Maine.

Responsibilities

• Acts as a liaison between insurance, healthcare providers, and the clinic to ensure required referrals have been processed correctly for medical specialty visits.
• Schedules referrals for patients at the request of providers and/or staff.
• Communicates directly with clinics, referred clinics, and patients.
• Reviews clinical data to report medical necessity to insurance companies.
• Makes referrals to specialists for office practices along with prior auth and builds positive relationships with office practices and specialists.
• Performs tasks including filing/scanning patient reports, retrieving patient records for prior authorizations or medical records, and completing insurance prior authorizations.
• Conveys a positive image of the organization and maintains a positive customer-friendly attitude for both internal and external customers.

Requirements

• 2 years of experience in a clinic work environment preferred.
• Knowledge of medical terminology preferred.
• Completion of a medical assistant program desired.
• Certified within 6 months of hire.
• Knowledge of electronic medical systems.
• Excellent phone skills and customer service skills.
• A upbeat, positive, customer-friendly attitude towards internal and external customers.
• Knowledge of prior authorizations and insurance plans.
• Good organizational skills.
• Able to act as a patient liaison to help them navigate the healthcare system.
• A self-starter who can multi-task and solve scheduling and referral issues.
• Detailed oriented.
• Able to work in a changing environment.

Qualifications

• Completion of a medical assistant program desired.
• Certified within 6 months of hire.
• Knowledge of electronic medical systems.
• Excellent phone skills and customer service skills.
• A upbeat, positive, customer-friendly attitude towards internal and external customers.
• Knowledge of prior authorizations and insurance plans.
• Good organization skills.
• Able to act as a patient liaison to help them navigate the healthcare system.
• A self-starter who can multi-task and solve scheduling and referral issues.
• Detailed oriented.
• Able to work in a changing environment.

Skills

• Knowledge of medical terminology.
• Ability to communicate effectively with patients and healthcare providers.
• Strong organizational and problem-solving skills.
• Ability to handle multiple tasks and prioritize effectively.
• Knowledge of insurance plans and prior authorizations.
• Positive and professional demeanor.

Benefits

Central Maine Medical Center offers competitive benefits including health insurance, retirement plans, and paid time off.

Pay

The salary range for this position is $XX/X per hour, depending on experience and qualifications.

Schedule

This is a full-time day shift position.