Care Access & Referrals Specialist

Boone Memorial Hospital Inc; Madison (WV); On-site; USD 38,000 - 48,000; Full time

Job summary

Boone Memorial Health is seeking a Referral Specialist to join our healthcare team. The Referral Specialist coordinates patient referrals, insurance authorizations, and appointment scheduling to ensure timely access to services.

This role collaborates with patients, families, physicians, providers, and insurance companies to navigate the healthcare system. Responsibilities include processing referrals, obtaining authorizations, scheduling, documenting demographics, and maintaining logs.

Qualifications

• High school diploma or GED required.
• Minimum of two (2) years of experience with patient referrals, medical scheduling, insurance authorizations, or a related healthcare function required.
• Knowledge of medical terminology and commonly used medical abbreviations.
• Knowledge of diagnosis and CPT-10 coding.
• Strong organizational and time-management skills.
• Excellent communication and interpersonal skills.
• Strong attention to detail and accuracy.
• Ability to work independently and manage multiple tasks and deadlines.

Responsibilities

• Coordinate patient referrals accurately and efficiently.
• Obtain insurance authorizations and follow up on pending requests.
• Schedule patient appointments and coordinate services with providers and healthcare facilities.
• Verify and maintain accurate patient demographics and insurance information.
• Maintain referral records, tracking logs, and follow-up documentation.
• Monitor referral status and ensure referrals are completed in a timely manner.
• Respond to patient, provider, and insurance inquiries by telephone and other communication methods.
• Document referral information accurately in CPSI/Medical Records and other required systems.
• Advocate for patients with insurance carriers to obtain approval for necessary services and supplies.

Skills

Organizational skills

Time-management

Communication skills

Interpersonal skills

Attention to detail

Customer service

Problem-solving

Patient advocacy

Education

High school diploma or GED

Job description

Boone Memorial Health is seeking a Referral Specialist to join our healthcare team. The Referral Specialist coordinates patient referrals, insurance authorizations, and appointment scheduling to ensure timely access to services.

This role collaborates with patients, families, physicians, providers, and insurance companies to navigate the healthcare system. Responsibilities include processing referrals, obtaining authorizations, scheduling, documenting demographics, and maintaining logs.