Referral Specialist
US-NE-KEARNEY
commonspirit_careers
Req #: 423366
Type: Day
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Overview: The Referral Specialist works with patients requiring a referral, to ensure patient's referral needs are fulfilled for specialty service office visits. Processes referrals, authorizations and pre-certifications for patients, to ensure timely reimbursement. Responsibilities: * Gather, verify, and process referrals, authorizations, and pre-certifications by working closely with physician(s), patients, and payers. * Communicate detailed information and answers patients' questions regarding their health care plan; provide answers to billing and insurance clarification questions. * Set up appointments, coordinate clinic visits, and any special arrangements such as transportation, interpreter services, specialty care, etc. * Coordinate flow of information between medical clinic and referral authorization department to secure a valid referral for clinic patient. * Enter referrals, documents communications and action into the system, as appropriate. * Notify physician(s) and patient when referral is denied, or if additional information is needed. * Develop and maintain database of referral physician offices preferred by each physician within the clinic. * Assist Practice Manager with complaint resolution and solutions related to patient referrals. * Perform other duties as assigned by the practice manager or physician. Qualifications: Qualifications * High school diploma or equivalent required. * 2 years of progressively responsible related experience in a healthcare environment required.
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