Referral & Authorization Specialist (Day Shift)

Trinity Health; Hartford (CT); On-site; USD 42,000 - 68,000; Full time

Benefits offered by this job

40 hours, Day shift

Great benefits effective day 1

Growth Opportunities

Inclusive Culture

Job summary

Trinity Health is seeking a Referral Support Specialist in Hartford, CT to work with the referrals team and clinical staff. The role involves managing Epic referrals, prescreening for completeness, and coordinating pre-authorizations with insurance companies, while ensuring patient registration accuracy and PCP selection.

The position requires healthcare experience and proficiency with Microsoft Office; Epic experience is preferred.

Qualifications

• High Diploma or equivalent.
• Minimum of three (3) years’ experience in healthcare preferred.
• Experience in a medical office or billing department preferred.
• Medical terminology preferred.
• Knowledge of patient billing preferred.
• Proficiency with Microsoft products (Word, Excel, Power Point and Outlook) required.
• EPIC experience preferred.

Responsibilities

• Process and maintain the Epic Referrals Workqueue prescreening for completeness of information, urgency, and other designated criteria.
• Complete pre-authorization workflows as required; contact insurance companies to ensure prior approval requirements are met.
• Review and update patient registration for membership eligibility and PCP selection.
• Enter referrals into the system per Trinity Health Of NE MGPS per protocols and provide feedback to ordering provider as needed.
• Inform maintenance analyst/resource library of payor, benefit specific information and provider contact updates accordingly.
• Answer incoming phone calls as required to assist all internal and external customers by offering guidance and support for referral related questions, process and problems.
• Other duties as assigned by Manager and Supervisor.

Skills

Microsoft Office

EPIC

Healthcare experience

Communication

Medical terminology

Education

High Diploma or equivalent

Tools

EPIC system

Microsoft Word

Excel

Outlook

Job description

Trinity Health is seeking a Referral Support Specialist in Hartford, CT to work with the referrals team and clinical staff. The role involves managing Epic referrals, prescreening for completeness, and coordinating pre-authorizations with insurance companies, while ensuring patient registration accuracy and PCP selection.

The position requires healthcare experience and proficiency with Microsoft Office; Epic experience is preferred.