Referral Representative

IHA; Hartford (CT); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Great benefits effective day 1

Competitive pay

Growth opportunities

Inclusive culture

Job summary

IHA in Hartford, CT is seeking a Full-time Referrals Support Specialist to help maintain the referral workflow. You will work with clinical and customer service staff to ensure efficient processing of referrals.

Responsibilities include prescreening Epic referrals, handling pre-authorization with insurers, updating patient registrations, and entering referrals per protocols. The role requires strong Microsoft Office skills and EPIC experience.

Qualifications

• High Diploma or equivalent.
• 3+ years of healthcare experience; medical office or billing experience preferred.
• Medical terminology and patient billing knowledge preferred.
• Proficiency with Microsoft Office; EPIC experience preferred.

Responsibilities

• Process and prescreen electronic Epic Referrals Workqueue for completeness and urgency.
• Complete pre-authorization workflows and contact insurers for prior approvals.
• Review and update patient registration for membership eligibility and PCP selection.
• Enter referrals into the system per protocols and provide feedback to ordering providers.
• Inform maintenance analyst or resource library of payor, benefit, and provider updates.
• Answer incoming calls to assist internal and external customers with referral questions.
• Perform other duties as assigned by Manager and Supervisor.

Skills

Excellent organizational skills

Excellent oral and written comms

Ability to multi-task

Education

High Diploma or equivalent

Tools

Microsoft Word

Excel

PowerPoint

Outlook

EPIC

Job description

Employment Type

Full time

Shift

Day Shift

Description

Position Purpose: Working under the direction of the Referrals Supervisor, this position is responsible providing a variety of support services which are essential to the efficient operation of the organization’s referral process. Works closely with the clinical department staff as well customer service staff in the offices.

What You Will Do

• Process and maintain the electronic Epic Referrals Workqueue prescreening for completeness of information, urgency, and other designated criteria
• Completes pre-authorization workflows as required. Contact insurance companies to ensure prior approval requirements are met.
• Reviews and updates patient registration for membership eligibility and PCP selection.
• Enters referrals into the system per Trinity Health Of NE MGPS per protocols and provides feedback to ordering provider as needed.
• Informs maintenance analyst/ resource library of payor, benefit specific information and provider contact information updates accordingly
• Answers 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

Minimum Qualifications

• High Diploma or equivalent
• Minimum of three (3) years’ experience in healthcare preferred. Experience within a medical office or billing department preferred. Medical terminology preferred. Knowledge of patient billing preferred.
• Proficiency with all Microsoft products (Word, Excel, Power Point and Outlook) required. EPIC experience preferred.
• Excellent organizational skills and ability to multi-task. Excellent oral and written communication skills. Ability to evaluate and manage multiple priorities and demonstrate follow-through.

Position Highlights And Benefits

• 40 hours, Day shift
• Great benefits effective day 1!
• Competitive pay!
• Growth Opportunities!
• Inclusive Culture!

We are a group of primary care providers, specialists and surgeons serving patients in Connecticut and western Massachusetts. Part of Trinity Health Of New England, we offer primary care, specialty care, surgery, urgent care, rehabilitation, and imaging and lab services for thousands of patients every year.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care.

We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.