Referral Operations Specialist

Trinity Health; United States; On-site; USD 48,000 - 60,000; Full time

Benefits offered by this job

Great benefits effective day 1!

Growth Opportunities!

Inclusive Culture!

Competitive pay!

Job summary

Trinity Health is seeking a Referrals Specialist to support the referral process in a day shift, full-time role. Under the direction of the Referrals Supervisor, this position processes referrals, coordinates pre-authorization activities with insurance, and updates patient registration to ensure accurate PCP selection.

Responsibilities include entering referrals in EPIC, communicating with providers, and assisting internal/external customers with referral inquiries.

Qualifications

• High Diploma or equivalent is required.
• Minimum of three years’ experience in healthcare is preferred, preferably in a medical office or billing department.
• Medical terminology knowledge is preferred.
• Knowledge of patient billing is preferred.

Responsibilities

• Process and maintain the electronic Epic Referrals Workqueue prescreening for completeness of information, urgency, and other design. criteria.
• Complete pre-authorization workflows; contact insurance companies to ensure prior approvals are met.
• Review and update patient registration for membership eligibility and PCP selection.
• Enter referrals into the system per protocols and provide feedback to ordering provider.
• Inform maintenance analyst/resource library of payor, benefit specific information and provider contact updates.
• Answer incoming calls to assist internal and external customers with referral questions and issues.
• Other duties as assigned by Manager and Supervisor.

Skills

Microsoft Office

EPIC EHR

Healthcare experience

Communication skills

Education

High Diploma or equivalent

Tools

EPIC

Microsoft Office

Job description

Trinity Health is seeking a Referrals Specialist to support the referral process in a day shift, full-time role. Under the direction of the Referrals Supervisor, this position processes referrals, coordinates pre-authorization activities with insurance, and updates patient registration to ensure accurate PCP selection.

Responsibilities include entering referrals in EPIC, communicating with providers, and assisting internal/external customers with referral inquiries.