Referrals Specialist III #Full Time

61st Street Service Corporation; New Jersey; Remote; USD 10,000 - 60,000; Full time

Job summary

An established industry player is seeking a dedicated Referrals Specialist III to join their team. This role involves verifying insurance benefits and securing necessary referrals, ensuring a seamless experience for patients. The ideal candidate will possess strong customer service skills and a keen understanding of managed care eligibility. With opportunities for growth within the Revenue Cycle Career Ladder, you will be part of a supportive environment that values collaboration and excellence. If you are motivated and ready to make a difference in healthcare, this position is perfect for you.

Benefits

Healthcare Benefits

Paid Time Off

Competitive Salary

Training Opportunities

Qualifications

• 2+ years experience in physician billing or third-party payer environment.
• Strong customer service skills and ability to navigate complex situations.

Responsibilities

• Verify insurance coverage and secure payer required referrals.
• Assist management with daily work assignments and staff training.

Skills

Insurance Verification

Customer Service

Multi-tasking

Medical Terminology

Communication Skills

Education

High School Diploma or GED

Tools

Microsoft Word

Microsoft Excel

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. ColumbiaDoctors’ practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specialties and subspecialties.

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

Note: There may be occasional requirements to visit the office for training, meetings, and other business needs.

Opportunity to grow as part of the Revenue Cycle Career Ladder!

Job Summary:

The Referrals Specialist III is responsible for verifying insurance policy benefit information, and securing payer required referrals. This position is responsible for obtaining accurate and timely insurance referrals for professional services prior to the patient’s visit. This position may also be required to obtain prior authorizations for scheduled services, as needed. The Referrals Specialist III is also responsible for assisting management with the daily work assignment, staff training, and quality audits.

Job Responsibilities:

• Verifies insurance coverage via system tools, payer portals (Electronic Query (Real-Time-Eligibility [RTE]/Insurance Payer Portal/Phone).
• Upon verification of patient's insurance coverage, update changes in the billing system.
• Confirms provider’s participation status with patient’s insurance plan/network.
• Determines payer referral and authorization requirements for professional services.
• Contacts patient and PCP to secure payer required referral for planned services.
• Documents referral in practice management system.
• Research system notes to obtain missing or corrected insurance or demographic information.
• Initiates authorization and submits clinical documentation as requested by insurance companies.
• Manage faxes, emails, and phone calls in a timely manner. Responds to voicemails and emails within same business day of receipt.
• Serves as primary liaison between faculty practice/department, insurance companies and patient to verify eligibility and coordination of benefits and resolve any insurance complications.
• Assists Supervisor with special projects and/or tasks.
• Assists Referrals Specialist I and II with complex cases or questions pertaining to the clearance of payer referrals, authorization, or insurance eligibility issues.
• Assist supervisor/manager with distribution of daily work assignments.
• Assist with new-hire training and staff refresher training materials.
• Monitor and replenish the unit’s office supply needs.
• Assist management team with performing periodic quality audit.
• Perform other job duties as assigned.

Job Qualifications:

• High school graduate or GED certificate is required.
• A minimum of 2 years’ experience in a physician’s billing or third payer environment.
• Candidate must demonstrate the ability to understand and navigate managed care eligibility, insurance billing requirements, and obtaining pre-authorizations.
• Candidate must demonstrate strong customer service and patient focused orientation and the ability to communicate, adapt, and respond to complex situations. Including the ability to diffuse complex situations in a calm and professional manner.
• Must demonstrate effective communication skills both verbally and written.
• Ability to multi-task, prioritize, document, and manage time effectively.
• Functional proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.)
• Functional proficiency and comprehension of medical terminology.
• Ability to work independently and collaborate in teams.
• The ideal candidate is a motivated individual with a positive attitude and exceptional work ethic.
• Experience in Epic and or other electronic billing systems is preferred.
• Knowledge of medical terminology, diagnosis and procedure coding is preferred.
• Previous experience in an academic healthcare setting is preferred.

Hourly Rate Ranges: $27.40 - $36 .06

Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education.

61st Street Service Corporation

At 61st Street Service Corporation we are committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a competitive comprehensive Benefit package to eligible employees; including Healthcare and various other benefits including Paid Time off to promote a healthy lifestyle.

We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.