Referral & Authorization Specialist

EngageMED, Inc.; North Little Rock (AR); Sur place; USD 40 000 - 55 000; Plein temps

Résumé du poste

Catholic Health Initiatives is seeking a Referral Specialist to manage referrals, authorizations and pre-certifications for patients requiring specialty care. You will work closely with physicians, patients and payers to ensure timely referrals and clear billing information.

The role involves setting up appointments, coordinating travel or interpreter services as needed, and maintaining accurate referral records.

Qualifications

• High school diploma or equivalent required.
• 2 years of progressively responsible related experience in a healthcare environment.
• Knowledge of clinic referral, scheduling, and billing/authorization requirements.
• Ability to communicate effectively and maintain confidentiality.
• Proficient with Microsoft Office Suite, Internet navigation, database management, spreadsheet, and graphic presentation packages.

Responsabilités

• 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.

Connaissances

Teamwork Orientation

Service Orientation

Achieves Results

Learning and Growth

Communication

Confidentiality

Multitasking

Formation

High School Diploma or equivalent

Outils

Microsoft Office Suite

Internet navigation

Database management

Spreadsheet

Desktop publishing

Description du poste

Catholic Health Initiatives is seeking a Referral Specialist to manage referrals, authorizations and pre-certifications for patients requiring specialty care. You will work closely with physicians, patients and payers to ensure timely referrals and clear billing information.

The role involves setting up appointments, coordinating travel or interpreter services as needed, and maintaining accurate referral records.