Referral Specialist
CommonSpirit Health
Overview
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
CHI Health strives to care for you the way you care for your patients.
We understand you have personal responsibilities outside of your profession and also care about your well-being.
With you in mind, we offer the following benefits to support your work/life balance:
Health/Dental/Vision Insurance Direct Primary Plan (No copay, no deductible, and access to CHI Health provider 24/7)Premium Access to our Family Care Program supporting your needs for childcare, pet care, and/or adult dependent care Voluntary Protection: Group Accident, Critical Illness, and Identity Theft Employee Assistance Program (EAP) for you and your family Paid Time Off (PTO) Tuition Assistance for career growth and development Matching 401(k) and 457(b) Retirement Programs Adoption Assistance Wellness ProgramsFlexible spending accountsFrom primary to specialty care as well as walk-in and virtual services CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy. We offer more than 20 specialties and 100 convenient locations; with some clinics offering extended hours.
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
Required Minimum Knowledge, Skills, Abilities and Training
2 years of progressively responsible related experience in a
Health care environment required.
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