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)
Summary: The Access and Referral Specialist reports to a Patient Access Supervisor. Under the general supervision ensures the quality of the referral process is upheld to departmental standards. Evaluates the incoming referral for information that is accurate and appropriately reflects the patient symptom to the requested treatment. Ensures quality control of the referral process is upheld by reviewing the accuracy and timeliness of referrals through monthly standard reports. Coordinates the effective and efficient processing and scheduling of all incoming referrals adhering to established timelines and departmental procedures.
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Other information:
Lifespan is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Lifespan is a VEVRAA Federal Contractor.
Location: Rhode Island Hospital USA:RI:Providence
Work Type: Per Diem
Shift: Shift 1
Union: Non-Union