Referral Specialist

Intermountain Healthcare Inc.; Las Vegas (NV); On-site; USD 27,000 - 39,000; Full time

Benefits offered by this job

Benefits package

Day shift

40 hours/week

Job summary

Intermountain Health in Las Vegas, NV is seeking a Referral Specialist to serve as the first connection between Intermountain and patients, focusing on building collaborative relationships with patients and staff to deliver exceptional service.

You will verify eligibility, obtain authorizations, submit and track referrals, coordinate with hospitals, physicians, health plans and clinics, and ensure timely, accurate information flow to support patient care.

Qualifications

• Experience in referral services or related field.
• Ability to verify eligibility and obtain authorizations.
• Strong communication and attention to detail.

Responsibilities

• Identify and resolve patient, provider, and staff requests including referrals and scheduling.
• Verify eligibility/benefits; obtain authorizations and track referrals.
• Serve as liaison among hospitals, physicians, plans, vendors, and patients.
• Follow three-touch process: MyChart, phone, and letter.
• Forward medical records and authorization information to providers.

Skills

Medical terminology

Computer literacy

Customer service

EMR (Electronic Medical Records)

Data entry

Problem solving

Written/oral communication

Detail oriented

Critical thinking

Analytical thinking

Interpersonal skills

Education

Associate or higher degree

Tools

EMR systems

Insurance portals

Job description

Job Description:The Referral Specialist is the first connection between Intermountain and patients and is responsible to focus on establishing collaborative relationships with patients and fellow caregivers (employees) to deliver the highest level of customer/patient satisfaction. Referral Specialists are responsible for fostering relationships with patients, parents and guardians regarding the patient's care to include ensuring compliance with managed care, commercial insurance, and public insurance requirements, submitting and tracking referrals, and providing efficient patient flow and service excellence.Posting SpecificsBenefits Eligible: YesShift Details: Monday - Friday 8:30am to 5:00pmEssential FunctionsEffectively identifies and resolves patient, provider, and staff requests which may include; referral processing, scheduling/registration, business/billing/payor inquiries, and medical requests.Uses analytical skills and technical resources to anticipate and resolve patient requests, demonstrates critical thinking and problem solving during challenging patient interactions and situations with ability to recognize and follow appropriate procedures for medical and non-medical emergencies.Contributes to and supports enterprise productivity and quality measures/initiatives by participating, planning, communicating, and encouraging team and individual contributions toward Intermountain Health Key Performance Indicators.Verifies eligibility and benefits; obtains authorizations, and tracks referrals to ensure compliance with guidelines.Acts as a liaison between hospitals, physicians, health plans, vendors and patients or other referral sources to submit for insurance authorization for procedures, specialist visits for patients referred by an Intermountain primary care providerGathers pertinent information from insurance carriers, financial counselors and other ancillary staff to make certain of the patients’ financial obligations for services provided.Documents appropriate and complete information within the referral shell to include authorization information, location patient referred to close the loop, coordinating with teams, providers, staff, insurance companies, patients, and other clinics.Follows the three-touch process, reach out to patient via MyChart, phone call and letter.Forwards all pertinent medical records and authorization information referred to the provider’s office.SkillsMedical TerminologyComputer LiteracyCustomer ServiceElectronic Medical Records (EMR)Data EntryProblem SolvingCommunication (Written/Oral)Detail OrientedCritical ThinkingAnalytical ThinkingInterpersonal skillsMinimum RequirementsDemonstrated experience using multiple business software applications and insurance web portals simultaneouslyPrior experience in healthcarePreferred RequirementsAssociate or higher level degreeOne year of experience with referral services, referral processing, authorization/referral claims administration or a directly related fieldPhysical RequirementsOngoing need for employee to see and read information, labels, monitors, identify equipment and supplies, and be able to assess customer needs.Frequent interactions with customers that require employee to communicate as well as understand spoken information, alarms, needs, and issues quickly and accurately.Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer, phone, and cable set-up and use.Expected to lift and utilize full range of movement to transport, pull, and push equipment. Will also work on hands and knees and bend to set-up, troubleshoot, lift, and carry supplies and equipment. Typically includes items of varying weights, up to and including heavy items.For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing and reading signs, traffic signals, and other vehicles.Location:Nevada Central OfficeWork City:Las VegasWork State:NevadaScheduled Weekly Hours:40The hourly range for this position is listed below. Actual hourly rate dependent upon experience.$19.41 - $28.14We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.At Intermountain Health, we use the artificial intelligence (\"AI\") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.All positions subject to close without notice.