Referral Representative - MA

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

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!

EEO Statement

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. EOE including disability/veteran