Referrals Specialist I #Full Time #Remote

61st Street Service Corporation; Poland; Hybrid; PLN 121,000 - 148,000; Full time

Job summary

61st Street Service Corporation is seeking a Referrals Specialist I to verify insurance benefits and secure payer referrals for professional services. This remote role supports ColumbiaDoctors in the Tri-State area, with occasional on-site training as needed.

The position emphasizes accuracy in referrals, prior authorizations when required, and strong customer service aligned with a busy physician billing environment.

Qualifications

• High school graduate or GED required.
• Minimum 6 months’ physician billing or third payer experience.
• Experience understanding managed care eligibility and pre-authorizations.
• Excellent communication and customer service skills; ability to handle complex situations calmly.
• Proficient with Word, Excel, Outlook and general software tools.

Responsibilities

• Verifies insurance coverage via payer portals and real-time-eligibility queries.
• Updates billing system with coverage changes after verification.
• Confirms provider participation with patient’s plan/network.
• Determines referral/authorization requirements for professional services.
• Contacts patient and PCP to secure referrals for planned services.
• Documents referrals in the practice management system.
• Researches notes to obtain missing insurance or demographic information.
• Initiates authorizations and submits requested documentation.
• Manages faxes, emails, and calls; responds within one business day.
• Acts as liaison between faculty, insurers and patient to resolve issues.

Skills

Customer service

Communication

Multi-tasking

Microsoft Office

Education

High school diploma

Tools

Epic

Job description

Career Opportunities with 61st Street Service Corp

Current job opportunities are posted here as they become available.

Referrals Specialist I #Full Time #Remote

The 61st Street Service Corporation, provides administrative and clinical support staff for ColumbiaDoctors. This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors’ practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specialties and subspecialties.

This position is primarily remote, candidates must reside in the Tri-State area.

Note: There may be occasional requirements to visit the office for training, meetings, and other business needs.

Opportunity to grow as part of the Revenue Cycle Career Ladder!

Job Summary:

The Referrals Specialist I is responsible for verifying insurance policy benefit information, and securing payer required referrals. This position is responsible for obtaining accurate and timely insurance referrals for professional services prior to the patient’s visit. This position may also be required to obtain prior authorizations for scheduled services, as needed.

Job Responsibilities:

• Verifies insurance coverage via system tools, payer portals (Electronic Query (Real-Time-Eligibility [RTE]/Insurance Payer Portal/Phone).
• Upon verification of patient's insurance coverage, update changes in the billing system.
• Confirms provider’s participation status with patient’s insurance plan/network.
• Determines payer referral and authorization requirements for professional services.
• Contacts patient and PCP to secure payer required referral for planned services.
• Documents referral in practice management system.
• Research system notes to obtain missing or corrected insurance or demographic information.
• Initiates authorization and submits clinical documentation as requested by insurance companies.
• Manage faxes, emails, and phone calls in a timely manner. Responds to voicemails and emails within same business day of receipt.
• Serves as primary liaison between faculty practice/department, insurance companies and patient to verify eligibility and coordination of benefits and resolve any insurance complications.
• Performs other job duties as assigned.

Job Qualifications:

• High school graduate or GED certificate is required.
• A minimum of 6 months’ experience in a physician’s billing or third payer environment.
• Candidate must demonstrate the ability to understand and navigate managed care eligibility, insurance billing requirements, and obtaining pre-authorizations.
• Candidate must demonstrate strong customer service and patient focused orientation and the ability to communicate, adapt, and respond to complex situations. Including the ability to diffuse complex situations in a calm and professional manner.
• Must demonstrate effective communication skills both verbally and written.
• Ability to multi-task, prioritize, document, and manage time effectively.
• Functional proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.)
• Functional proficiency and comprehension of medical terminology.
• Ability to work independently and collaborate in teams.
• The ideal candidate is a motivated individual with a positive attitude and exceptional work ethic.
• Experience in Epic and or other electronic billing systems is preferred.
• Knowledge of medical terminology, diagnosis and procedure coding is preferred.
• Previous experience in an academic healthcare setting is preferred.

Hourly Rate Ranges: $23.56 - $28.85

Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education.

61st Street Service Corporation

At 61st Street Service Corporation we are committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a competitive comprehensive Benefit package to eligible employees; including Healthcare and various other benefits including Paid Time off to promote a healthy lifestyle.

We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.