Referral Representative (51844)

HealthLinc; South Bend (IN); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Health benefits

Job summary

HealthLinc in South Bend, IN is seeking a Referral Representative to act as a liaison between patients, providers, and specialty sites. The role involves verifying eligibility, coordinating referrals, and maintaining documentation.

Required are a high school diploma (some college preferred) and 1–2 years in medical administration plus customer service experience. Strong organization, communication skills, and teamwork are essential.

Qualifications

• High school diploma or equivalent required; some college preferred.
• 1–2 years of experience in a medical administrative position.
• 1–2 years of customer service experience.
• Strong organizational and time management skills.
• Excellent verbal and written communication skills.
• Ability to follow HealthLinc policies and procedures.

Responsibilities

• Organizes referrals to specialists and acts as a resource for patients and staff regarding referral processes.
• Checks Medicaid, Medicare, and private insurance websites for coverage.
• Completes referral information for patients as requested by Providers.
• Maintains and updates referral resource binder.
• Manages open referral orders and follows up with all parties involved.
• Assists with patient phone calls and questions.
• Coordinates patients' medical information flow with specialty clinics.
• Obtains prior authorization for specific testing.
• Follows quality improvement initiatives aligned with PCMH.
• Performs other duties as assigned.

Skills

Strong organizational skills

Time management

Customer service

Verbal and written communication

Team player

Education

High school diploma or equivalent

Some college (preferred)

Tools

Microsoft Office

EHR systems

Job description

Job Details

Job Location: Centennial - South Bend, IN 46600

Position Type: Full Time

Education Level: High School

Travel Percentage: None

Job Shift: Day

As a Referral Representative, you will act as a liaison between patients, our providers, and specialty sites; check patient eligibility and maintain accurate and timely documentation. This position will report to the Assistant Site Operations Director.

JOB RESPONSIBILITIES

• Organizes appropriate referrals to specialists and remains a resource for patients and staff regarding the referral agencies and process.
• Checks Medicaid, Medicare, and private insurance websites for patients provider coverage.
• Completes referral information for patients as requested by the Providers.
• Maintains and updates referral resource binder.
• Manages open referral orders by finding documents and follows up with all parties involved.
• Assists with patient phone calls and questions.
• Follows up with specialty clinics to coordinate patients medical information flow.
• Maintains accurate and timely documentation.
• Obtain prior authorization for specific testing.
• All HealthLinc staff is committed to engage in quality improvement initiatives that align with and support Patient-Centered Medical Home (PCMH).
• Perform other duties as assigned.

QUALIFICATIONS

REQUIRED QUALIFICATIONS:

Education/Training

• High school diploma or equivalent
• Some college (not required but highly preferred)

Experience

• At least 1-2 years of experience in a medical administrative position
• At least 1-2 years of experience in a customer service position

Skills/Job Requirement

• Strong organizational and time management skills
• Strong customer service skills
• Proven ability to work well in a team environment
• Excellent verbal and written communication skills
• Proven experience with basic medical terminology (not required but highly preferred)
• Ability to follow HealthLinc policies and procedures

Technology Skills

• Operate a multi-line phone system and other office equipment including printers, fax machines, etc.
• Basic computer skills (Microsoft Office, EHR, online sources, etc.)

DIRECT SUPERVISION

N/A

REQUIRED TRAINING

• All assigned Relias training