Referrals Specialist

Description

Accurately receive and process authorization requests promptly, ensuring completeness and high-quality work.
Coordinate and schedule referrals and treatment authorization requests efficiently.
Secure authorizations from various insurance providers through phone, written communication, email, or fax, while adapting to evolving organizational processes.
Proactively follow up on outstanding or missing documentation needed to complete authorizations.
Arrange appointments for specialty services, diagnostic tests, Durable Medical Equipment (DME), and other support services as ordered by the primary care provider.
Manage and coordinate patient care in accordance with guidelines from multiple insurance plans, contracts, and coverage types.
Utilize different system applications to access information, schedule services, track referrals, and obtain authorizations.
Provide timely and accurate updates on authorization status by evaluating requests and communicating relevant information to patients.
Maintain a professional demeanor in both verbal and nonverbal communication, adapting style based on the audience.
Listen attentively to patient concerns, whether over the phone or in person, and respond appropriately to meet their needs.
Foster collaboration by considering and incorporating diverse perspectives.
Consistently meet established deadlines and performance expectations.
Manage referral closure processes by reviewing referral logs regularly to verify patient appointment completion.
Update referral records with appointment details, including date and time.
Confirm whether patients attended scheduled appointments and follow up with specialists or facilities to obtain visit notes or test results.

Additional Skills & Qualifications

• Bilingual English/Spanish is required. They must be fully fluent in Spanish.
• A minimum of 1 year experience working in a healthcare setting to include both front and back office and/or referral authorization experience, as well as knowledge of different health plans, programs, and eligibility guidelines.
• At least 2 years of customer service experience.
• Schedule is M-F, 8-5.
• Coding and Data Processing or Medical Assistant Certificate are helpful.

Job Type & Location

This is a Contract position based out of San Diego, CA.

Pay And Benefits

The pay range for this position is $25.00 - $25.00/hr.

Requirements

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership.

About TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities.

San Francisco Fair Chance Ordinance

Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.