Referral Management Specialist — Hybrid

Beth Israel Lahey Health; Boston (MA); Hybrid; USD 32,000 - 41,000; Full time

Job summary

Beth Israel Lahey Health's Managed Care Coordinator role offers a hybrid work model with on-site two days a week in Boston and flexible remote work the rest. The position promotes collaboration with physicians, patients and staff to coordinate referrals and authorizations for multiple payers, while ensuring compliance with contractual rules.

The anticipated schedule is 8am-4:30pm, with duties including patient education about the referral process, data entry into Excel, and generating routine

Qualifications

• High School diploma or GED required; Associate’s degree preferred.
• 1-3 years related work experience required.
• Experience with computer systems including web-based applications and Microsoft Office (Outlook, Word, Excel, PowerPoint or Access) preferred.

Responsibilities

• Collaborates with referring physicians, patients and support staff to request, obtain, record, and attach primary and/or specialty care managed care referral and authorization requests for multiple managed care insurance payers for a high volume of patients.
• Utilizes electronic technologies to initiate, request, and procure a high volume of referral and authorizations for multiple managed care payers.
• Educates patients about the referral process, programs offered, and services provided at BIDMC and affiliated CareGroup institutions.
• Communicates with managed care payers to resolve patient referral management issues. Coordinates referrals with hospital’s discharge planner and registration and pre-certification admitting department as required by the insurance company.
• Provides referral management training and oversight to department new hires. Serves as a managed care resource for the unit.
• Runs daily, weekly, and monthly statistical referral management and booking reports; enters data obtained from the reports into Excel spreadsheets.
• Coordinates daily with the Referral Specialist and the support staff team in running referral management reports and enters information daily; collaborates on negative indicators to improve outcomes.

Skills

Written Communications

Oral Communications

Team Work

Customer Service

Problem Solving

Decision Making

Knowledge

Education

High School diploma or GED

Associate’s degree preferred

Job description

Beth Israel Lahey Health's Managed Care Coordinator role offers a hybrid work model with on-site two days a week in Boston and flexible remote work the rest. The position promotes collaboration with physicians, patients and staff to coordinate referrals and authorizations for multiple payers, while ensuring compliance with contractual rules.

The anticipated schedule is 8am-4:30pm, with duties including patient education about the referral process, data entry into Excel, and generating routine