Medical/Dental Referrals Representative

Langley Health Services; Ocala (FL); On-site; USD 36,000 - 48,000; Full time

Job summary

Langley Health Services in Ocala, FL seeks a detail-oriented Referral Representative to manage patient referrals, ensure documentation accuracy, and facilitate communication among patients, providers, and insurers.

The role emphasizes HIPAA compliance and knowledge of medical terminology and coding, with responsibilities including referral processing, authorization tracking, and appointment scheduling in a fast-paced environment.

Qualifications

• High School graduate or equivalent.
• Ability to work with minimum supervision and meet deadlines.
• Office and computer skills required.
• Strong interpersonal and communication skills.
• Commitment to enhancing the community and residents' health.
• Must be able to produce a high volume of work.
• Must be a self-starter.

Responsibilities

• Become familiar with and follow Langley Health Services policies, procedures, philosophies, goals, objectives, and applicable departmental processes.
• Process and coordinate medical and/or dental referrals as requested by Langley Health Services providers.
• Apply discretion and independent judgment when addressing issues related to referrals, authorizations, medical records, patient information, and referral coordination.
• Identify and coordinate appropriate specialty providers based on patient needs, insurance coverage, or lack of insurance.
• Schedule STAT or urgent referrals according to specialty, insurance requirements, and established departmental procedures, and accurately document referral activity in the appropriate system.
• Monitor referrals throughout the referral process to help ensure timely completion, authorization, scheduling, documentation, and closure.
• Process insurance authorizations and document authorization approvals or denials in the appropriate patient record.
• Schedule patient appointments when referral authorizations or other required approvals are received, in accordance with established procedures.
• For dental referrals, maintain appropriate treatment plan documentation and required patient signatures as applicable.
• If applicable, assist dental patients with questions regarding approved treatment plans and provide information to help ensure the patient understands the planned treatment and next steps.
• Accurately document and close completed referrals, including attaching applicable consultation reports, authorization information, or documentation explaining the reason for referral closure.
• Perform other duties and responsibilities as assigned

Skills

Interpersonal skills

Communication skills

Self-starter

Office skills

Computer skills

Work with minimum supervision

Education

High School diploma or equivalent

Job description

Job Overview

We are seeking a detail-oriented and organized Referral Representative to join our team. In this role, you will be responsible for managing patient referrals, ensuring that all necessary documentation is completed accurately and in a timely manner. You will play a critical role in facilitating communication between patients, healthcare providers, and insurance companies while adhering to HIPAA regulations and maintaining the confidentiality of medical records. The ideal candidate will have experience in a medical setting and possess strong knowledge of medical terminology and coding.

Job Overview

We are seeking a detail-oriented and organized Referral Representative to join our team. In this role, you will be responsible for managing patient referrals, ensuring that all necessary documentation is completed accurately and in a timely manner. You will play a critical role in facilitating communication between patients, healthcare providers, and insurance companies while adhering to HIPAA regulations and maintaining the confidentiality of medical records. The ideal candidate will have experience in a medical setting and possess strong knowledge of medical terminology and coding.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned:

• Become familiar with and follow Langley Health Services policies, procedures, philosophies, goals, objectives, and applicable departmental processes.
• Process and coordinate medical and/or dental referrals as requested by Langley Health Services providers.
• Apply discretion and independent judgment when addressing issues related to referrals, authorizations, medical records, patient information, and referral coordination.
• Identify and coordinate appropriate specialty providers based on patient needs, insurance coverage, or lack of insurance.
• Schedule STAT or urgent referrals according to specialty, insurance requirements, and established departmental procedures, and accurately document referral activity in the appropriate system.
• Monitor referrals throughout the referral process to help ensure timely completion, authorization, scheduling, documentation, and closure.
• Process insurance authorizations and document authorization approvals or denials in the appropriate patient record.
• Schedule patient appointments when referral authorizations or other required approvals are received, in accordance with established procedures.
• For dental referrals, maintain appropriate treatment plan documentation and required patient signatures as applicable.
• If applicable, assist dental patients with questions regarding approved treatment plans and provide information to help ensure the patient understands the planned treatment and next steps.
• Accurately document and close completed referrals, including attaching applicable consultation reports, authorization information, or documentation explaining the reason for referral closure.
• Perform other duties and responsibilities as assigned

Qualifications

• High School graduate or equivalent
• Ability to work with minimum supervision and adhere to deadlines
• Office and computer skills required
• Strong interpersonal and communication skills
• Commitment to enhancing the community and the health of its’ residents
• Must be able to produce a high volume of work
• Must be a self-starter

We are an equal opportunity employer and drug-free workplace.