Referrals Specialist I #Full Time

61st Street Service Corporation; New York (NY); Remote; USD 10,000 - 60,000; Full time

Job summary

Ein innovatives Unternehmen sucht einen Referrals Specialist I, der für die Verifizierung von Versicherungsleistungen und das Einholen von Überweisungen verantwortlich ist. Diese Rolle erfordert eine enge Zusammenarbeit mit Patienten und Versicherungsunternehmen, um sicherzustellen, dass alle erforderlichen Genehmigungen rechtzeitig vorliegen. In einem dynamischen Umfeld werden Sie die Möglichkeit haben, innerhalb des Revenue Cycle Career Ladder zu wachsen. Das Unternehmen bietet ein unterstützendes Arbeitsumfeld mit wettbewerbsfähigen Vorteilen, um eine gesunde Work-Life-Balance zu fördern.

Benefits

Gesundheitsversorgung

Bezahlte Freizeit

Wettbewerbsfähige Vorteile

Qualifications

• Mindestens 6 Monate Erfahrung in der Abrechnung oder im Drittanbieterbereich.
• Fähigkeit, die Anforderungen an Managed Care und Versicherungsabrechnung zu verstehen.

Responsibilities

• Verifizieren Sie die Versicherungsdeckung über Systeme und Portale.
• Dokumentieren Sie Überweisungen im Praxisverwaltungssystem.

Skills

Kundenservice

Versicherungsabrechnung

Multitasking

Verbal und schriftliche Kommunikation

Medizinische Terminologie

Education

High School Diploma oder GED

Tools

Microsoft Word

Microsoft Excel

Outlook

Epic

Job description

Career Opportunities with 61st Street Service Corp

Current job opportunities are posted here as they become available.

The 61st Street Service Corporation provides administrative and clinical support staff for ColumbiaDoctors. This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast, comprising over 2,800 physicians, surgeons, dentists, and nurses across more than 240 specialties and subspecialties.

This position is primarily remote; candidates must reside in the Tri-State area.

Note: Occasional office visits may be required for training, meetings, and other needs.

Opportunity to grow within the Revenue Cycle Career Ladder!

Job Summary:

The Referrals Specialist I is responsible for verifying insurance policy benefits and securing payer-required referrals. The role involves obtaining accurate and timely insurance referrals before patient visits and may include obtaining prior authorizations for scheduled services as needed.

Job Responsibilities:

1. Verify insurance coverage through system tools, payer portals (Electronic Query (Real-Time-Eligibility [RTE]/Insurance Payer Portal/Phone).
2. Update billing system with changes after verifying insurance coverage.
3. Confirm provider’s participation status with the patient’s insurance plan/network.
4. Determine payer referral and authorization requirements for professional services.
5. Contact patients and PCPs to secure necessary referrals for planned services.
6. Document referrals in the practice management system.
7. Research system notes to obtain missing or corrected insurance or demographic information.
8. Initiate authorizations and submit required clinical documentation to insurance companies.
9. Manage faxes, emails, and phone calls promptly; respond within the same business day.
10. Serve as the primary liaison between the practice, insurance companies, and patients to verify eligibility, benefits, and resolve insurance issues.
11. Perform other duties as assigned.

Job Qualifications:

• High school diploma or GED required.
• At least 6 months’ experience in a physician’s billing or third-party payer environment.
• Ability to understand managed care eligibility, insurance billing, and pre-authorization processes.
• Strong customer service skills with a patient-focused approach; able to handle complex situations professionally.
• Effective verbal and written communication skills.
• Ability to multi-task, prioritize, document, and manage time efficiently.
• Proficiency in Microsoft Word, Excel, Outlook, and email.
• Understanding of medical terminology.
• Ability to work independently and in team settings.
• Motivated, positive attitude, and strong work ethic.
• Experience with Epic or other electronic billing systems is preferred.
• Knowledge of medical coding (diagnosis and procedures) is preferred.
• Previous experience in an academic healthcare setting is preferred.

Hourly Rate Range: $21.63 - $26.44

Note: Salary offers will be based on experience, skills, training, and education within this range.

About 61st Street Service Corporation

We are committed to excellent customer service and a productive environment. We offer competitive benefits, including healthcare, paid time off, and more, to support a healthy work-life balance.

We are an equal opportunity employer, adhering to all applicable civil rights laws.