About the position

The Referral Specialist position is a critical role within our award-winning network of health care clinics. This position is designed for individuals who are passionate about providing exceptional service to our patients and ensuring that they receive the necessary care through proper referral processes. As a Referral Specialist, you will be responsible for maintaining an up-to-date knowledge of various payer sources, including Fee for Service, Sliding Fee Scale, Managed Care/HMO, CHDP, and Healthy Families. Your expertise in these areas will be essential in navigating the complexities of health care reimbursement and ensuring that our patients have access to the services they need. In this role, you will handle member and patient inquiries regarding Treatment Authorization Requests (TAR) status and the authorization process. This will involve communicating effectively with patients to provide them with timely updates and information regarding their referrals. You will also be responsible for performing authorization data entry into the managed care system and maintaining referral logs. It is crucial that all referrals are tracked through to a completed visit, ensuring that our patients receive the highest level of care and support throughout their health care journey. We pride ourselves on being an equal employment opportunity employer, committed to considering all qualified candidates without regard to disability or protected veteran status. We are looking for a dedicated individual who is ready to contribute to our mission of providing outstanding health care services to our community.

Responsibilities

  • Maintains up to date knowledge about payer sources such as Fee for Service, Sliding Fee Scale, Managed Care/HMO, CHDP, Healthy Families
  • Handles member/patient inquiries regarding TAR status and the authorization process
  • Performs authorization data entry into the managed care system and referral logs
  • Ensures that all referrals are tracked through to a completed visit

Requirements

  • Knowledgeable about the regulations regarding various payer sources
  • Ability to handle member/patient inquiries effectively
  • Experience with authorization data entry and tracking referrals
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