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    Referral Specialist - Kearney, United States - Common Spirit

    Common Spirit
    Common Spirit Kearney, United States

    3 weeks ago

    Default job background
    Permanent
    Description
    Overview


    The Referral Specialist works with patients requiring a referral, to ensure patient's referral needs are fulfilled for specialty service office visits.

    Processes referrals, authorizations and pre-certifications for patients, to ensure timely reimbursement.

    Responsibilities


    • Gather, verify, and process referrals, authorizations, and pre-certifications by working closely with physician(s), patients, and payers.
    • Communicate detailed information and answers patients' questions regarding their health care plan; provide answers to billing and insurance clarification questions.
    • Set up appointments, coordinate clinic visits, and any special arrangements such as transportation, interpreter services, specialty care, etc.
    • Coordinate flow of information between medical clinic and referral authorization department to secure a valid referral for clinic patient.
    • Enter referrals, documents communications and action into the system, as appropriate.
    • Notify physician(s) and patient when referral is denied, or if additional information is needed.
    • Develop and maintain database of referral physician offices preferred by each physician within the clinic.
    • Assist Practice Manager with complaint resolution and solutions related to patient referrals.
    • Perform other duties as assigned by the practice manager or physician.
    Qualifications

    Qualifications


    • High school diploma or equivalent required.
    • 2 years of progressively responsible related experience in a healthcare environment required.
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