Referral Specialist jobs in Georgia

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. Additionally, Referral Specialist resolves pre-certification, registration, and case-related issues. Documents referrals, communications, actions, and other data in an information system. Generates and distributes all applicable forms, notifications, and paperwork. May require an associate degree. 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)

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Referral Specialist
  • Albany Area Primary Health Care
  • Newton, GA FULL_TIME
  • ALBANY AREA PRIMARY HEALTH CARE, INC. 

     

    JOB DESCRIPTION 

     

    REFERRAL SPECIALIST 

     

     

    JOB SUMMARY 

     

    Works under the direction of the Chief Quality Officer and part of the Quality Department to ensure coordination between internal and external resources is handled appropriately to ensure quality of care to the patient.  This individual will act as the first contact for referring physicians’ offices and new patients related to the referral process.  

     

     

    JOB CLASSIFICATION: 109     

     

     

    DUTIES AND RESPONSIBILITIES 

     

    1. Daily, check the referral log from the previous day and maintain that log in a timely mannerReferrals should be completed within 30 days. 

     

    1. Call patients back with referral information promptly 

     

    1. Document the referral cycle in the appropriate location 

     

    1. Obtain authorizations as needed and required 

     

    1. Answer the phone and handle call appropriately 

     

    1. Resolves pre-certification, registration, and case-related concerns prior to a patient's appointment 

     

    1. Responsible for verifying and securing authorizations/referrals for all visits and coordinating all outside referrals, appointments, and authorizations for outside diagnostic testing and other services. 

     

    1. Responsible for scheduling, tracking, and communicating with patients to ensure completion of all physician referrals. 

     

    1. Provide timely feedback to provider if referral appointment is not kept 

     

    1. Ensure that documentation is received back into patient’s medical record for all diagnostic testing and outside referral services 

     

    1. This individual is responsible for expediting the administrative requirements for the patient referrals in the clinic, ensuring that appropriate referrals are made to participating providers; with the patients' health plan 

     

    1. Understands and follows HIPAA requirements; conducts clinical/business processes that ensure patient’s rights to privacy and confidentiality as a priority 

     

    1. Women Health Clinic ONLY: (Scheduling Surgeries)  

    1. A. Refer and schedule patients for specialized testing, Cesarean deliveries, inductions, surgery, etc.  

    1. Track and monitor surgery appointments. Also schedule and obtain pre- authorization from patient’s insurance carrier for surgeries.  

    1. Schedule all surgeries: Communicate with hospital representative to schedule procedures at facility and communicate with patient pre-operative instructions.  

    1. Interact with operating room staff to ensure proper scheduling and any cancellations or changes in the schedule.  

    1. Work with other departmental schedulers within the hospital to effectively coordinate procedures based on availability of physician.  

    1. Maintain daily surgery schedule for physicians.  

    1. Accurately completed and pre-cert surgery case prior to surgery date.  

    1. Schedule and facilitate all patient appointments required prior to elective surgery. 

    1. Ensure patient is educated on Financial Obligation prior to surgery.  

    1. Answer phones, maintain and provide accurate information for the hospital and the patient.  

     

    EDUCATION, EXPERIENCE, AND SKILLS 

     

    High school graduate 

     

    Prior medical office experience required; MOA preferred 

     

    Prior training in customer service and public relations highly desirable 

     

    Ability to work under stress and an emphasis on excellent telephone communication skills 

     

    Ability to organize training materials specific to age and cultural diversity 

     

    TYPICAL PHYSICAL DEMANDS 

     

    Work requires physical hand dexterity and full range of motion for operation of switchboard and keyboardRequires sitting for extended periods of time, also stooping, bending, and stretching for files and supplies.  Occasionally lifting files or paper weighing up to 30 pounds.  Requires ability to hear within a normal rangeRequires ability to work under stressful or emergency situations with high concentration and energy level. 

     

     

    TYPICAL WORKING CONDITIONS 

     

    Work is performed in an office environment.  Involves frequent contact with patients and the public and telephone contact.  Work may be stressful at times.  Interaction with others.  Contact may involve dealing with angry or upset people.  Frequent pressure due to multiple calls and inquiries.  Occasional evening or weekend work. 

     

    JOB RELATIONSHIPS 

     

    Supervised by:        Operations Manager (Immediate Supervisor in clinic); and Chief     

                                                     Quality Officer  

     

    Employees Supervised: None 

     

    Revised: 09/21 

  • 19 Days Ago

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Referral specialist
  • Elevance Health
  • Columbus, GA FULL_TIME
  • Job Description Crisis and Referral Specialist Location : Remote A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior c...
  • 27 Days Ago

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Referral specialist
  • Elevance Health
  • Atlanta, GA FULL_TIME
  • Job Description Crisis and Referral Specialist Location : Remote A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior c...
  • 27 Days Ago

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Referral Specialist
  • Albany Area Primary Health Care
  • Albany, GA FULL_TIME
  • ALBANY AREA PRIMARY HEALTH CARE, INC. JOB DESCRIPTION REFERRAL SPECIALIST JOB SUMMARY Works under the direction of the Chief Quality Officer and part of the Quality Department to ensure coordination b...
  • 1 Month Ago

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Referral Management Specialist
  • Positive Impact Health Centers INC
  • Duluth, GA FULL_TIME
  • DescriptionAre you seeking a career with a growing company, a place where you can make an impact in the community? Then Positive Impact Health Centers is the company for you.Positive Impact Health Cen...
  • 19 Days Ago

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HIM/Referral Specialist
  • St. Joseph's/Candler
  • Savannah, GA FULL_TIME
  • HIM/Referral Specialist (MGM.2714) Duties: Provides customers access to healthcare provider by processing physician referrals. Provides patient appointments with speciality physician. Directly support...
  • 12 Days Ago

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Referral Specialist
  • Connecticut Institute For Communities Inc.
  • Danbury, CT
  • Connecticut Institute for Communities, Inc. Description: Job Description: Medical Referral Specialist We are seeking a c...
  • 3/28/2024 12:00:00 AM

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Referral Specialist (remote)
  • Morgan Stephens
  • Bethesda, MD
  • Job Title: Remote Referral Specialist Hours: Monday - Friday Two shifts: 7:30am - 4pm or 9am - 5:30pm Location: Full rem...
  • 3/28/2024 12:00:00 AM

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Admissions Referral Specialist
  • UHS
  • Doylestown, PA
  • Responsibilities We are currently hiring a full-time Admissions Referral Specialist to join our Intake team! We offer fl...
  • 3/28/2024 12:00:00 AM

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Referral Specialist
  • Catholic Health Initiatives
  • Minot, ND
  • **Overview** CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. Wi...
  • 3/27/2024 12:00:00 AM

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Referral Specialist
  • UCHealth
  • Aurora, CO
  • Description Location: UCHealth UCHlth 2450 Peoria Admin Services, US:CO:Aurora Department: UCHlth Patient Line Referrals...
  • 3/26/2024 12:00:00 AM

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Referral Specialist Primary Care
  • UHS
  • Aiken, SC
  • Responsibilities ABOUT AIKEN PHYSICIANS ALLIANCE Aiken Physicians Alliance is affiliated with Aiken Regional Medical Cen...
  • 3/26/2024 12:00:00 AM

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Claims Referral Specialist I
  • LIBERTY Dental Plan
  • Tustin, CA
  • Job Details Job Location LIBERTY Dental Plan of California - Tustin, CA Remote Type Hybrid Position Type Full Time Job S...
  • 3/26/2024 12:00:00 AM

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Referral Specialist (Accordia Pediatrics)
  • AltaPointe Health
  • Mobile, AL
  • Overview: Explore our job opportunities at AltaPointe.org, submit your online application, and then join us for Open Int...
  • 3/25/2024 12:00:00 AM

Georgia is a state in the Southeastern United States.Beginning from the Atlantic Ocean, the state's eastern border with South Carolina runs up the Savannah River, northwest to its origin at the confluence of the Tugaloo and Seneca Rivers. It then continues up the Tugaloo (originally Tugalo) and into the Chattooga River, its most significant tributary. These bounds were decided in the 1797 Treaty of Beaufort, and tested in the U.S. Supreme Court in the two Georgia v. South Carolina cases in 1923 and 1989. The border then takes a sharp turn around the tip of Rabun County, at latitude 35°N, thou...
Source: Wikipedia (as of 04/17/2019). Read more from Wikipedia
Income Estimation for Referral Specialist jobs
$38,883 to $47,833

Referral Specialist in Paramus, NJ
The information and referral series is designed to promote public access to a variety of services available through local agencies and programs.
January 20, 2020
Referral Specialist in Clarksville, TN
These referrals are for individuals requiring services related to quality early learning and licensed child care, and children, youth, and adults with developmental disabilities including Coordinated Information Peel, Respite Services and Kids Pathways Peel.
January 29, 2020
Referral Specialist in Fairbanks, AK
A referral specialist may be required to communicate via email and letter, phone, or in person.
December 12, 2019