Referral Specialist

Delta Health • Delta, CO

402d • $32,760 - $47,362

About The Position

The Referral Specialist plays a crucial role in the healthcare system by acting as a liaison between patients, healthcare providers, and insurance carriers. This position is responsible for gathering necessary information to confirm patients' financial obligations, processing referrals, verifying insurance coverage, and ensuring compliance with HIPAA regulations. The specialist will also assist in coordinating patient care and managing clerical functions within the clinic.

Requirements

• High school diploma or GED required.
• 2+ years of healthcare experience required.
• Health plan, billing and coding, and authorization intake experience preferred.
• Excellent written and verbal communication skills.
• Ability to manage multiple patients at once throughout different approval processes.
• Extensive knowledge of healthcare plans such as Medicare.
• Subject to a pre-employment background check and drug screen.

Nice To Haves

• Health plan, billing and coding, and authorization intake experience preferred.

Responsibilities

• Gathers pertinent information from patients, insurance carriers, financial counselors, and other staff to confirm the patient’s financial obligation for service.
• Acts as a liaison between hospital, clinical staff, health plans, providers, and patients to process referrals.
• Verifies insurance coverage and obtains required authorization when necessary.
• Documents referrals, communications, actions, and other data in the EMR.
• Generates and distributes all applicable forms, notifications, and paperwork.
• Assists the healthcare team in coordinating, prioritizing, and communicating patient, physician, and staff needs.
• Makes follow-up phone calls to patients regarding outstanding labs, procedures, and scheduling referrals.
• Communicates with providers to correct any referral changes.
• Responsible for all aspects of clerical functions within the clinic, including answering telephones, patient reminders, assisting visitors and family members, collection of payments, and scanning, organizing, and uploading all paper documents into the EHR.
• Prepares medical records files to release or transfer to providers, patients, insurance companies, and attorneys according to policy and procedure related to HIPAA compliance; copies and distributes records as appropriate.
• Helps maintain the day-to-day scheduling of patient appointments.
• Responsible for extracting old records from EHR systems and adding items to Athena Health.

Benefits

• Medical
• RX
• Dental
• Vision
• Retirement
• PTO
• Scholarships towards continued education
• Alternative coverage to include massage, acupuncture, and chiropractic care
• Employer paid Life and Disability coverage
• Paid Time Off
• 403B Plan - Up to a 3% retirement match

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED