Referral Specialist processes insurance pre-verification for hospital admissions or specialty service office visits. Gathers pertinent information from patients, insurance carriers, financial counselors, and other staff to confirm the patient's financial obligations for services. Being a Referral Specialist acts as a liaison between hospitals, clinical staff, health plans, providers, and patients to process referrals. Verifies insurance coverage and obtains required authorizations when necessary. Additionally, Referral Specialist documents referrals, communications, actions, and other data in an information management system. Generates and distributes all applicable forms, notifications, and paperwork. Requires a high school diploma. Typically reports to a supervisor. The Referral Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Referral Specialist typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
Physical Requirements:
The employee is regularly required to talk and hear. The employee is frequently required to stand, walk, sit, stoop, and reach. The employee must frequently lift and/or carry up to 20 pounds and occasionally lift and/or move 40 pounds or more. Specific vision abilities required by this job, include close vision, distance vision, color vision, depth perception, and the ability to adjust focus. The employee could be exposed to bodily fluids, communicable diseases, toxic substances, medicinal preparations, and other conditions common to a clinic environment.
Qualifications:
High School graduate or equivalent that has experience in computer data entry and medical terminology. Medical assisting certification is preferred.
Duties and Responsibilities:
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