Referral Specialist jobs in South Carolina

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
  • 270 Prisma Health Medical Group-Midlands
  • Columbia, SC FULL_TIME
  • Inspire health. Serve with compassion. Be the difference. Job Summary To provide our patients a seamless entry in to the Prisma Health experience. The Referral Specialist interfaces with patients and physician office team members to accurately authorize various consultations, procedures and tests. The Referral Specialist utilizes each patient’s preferred method of contact. The Referral Specialist utilizes various electronic medical records to transmit required clinical documentation to third party payors and Specialist Physicians. Responsibilities include documenting all actions and encounters regarding the referral including timely follow up with the patient, referring and referral physician practice and third party payors including pre-certification, cancelled and rescheduled appointments, and other events preventing closure of the referral experience. Accountabilities Responsible for the authorization/precertification process to include coordinating with outside and internal organizations along with insurance companies to ensure prior approval requirements are met. Presents necessary medical information such as history, diagnosis and prognosis. Provides specific medical information to financial services to maximize reimbursement to the hospital and physicians. Accurately records demographic, coverage, and scheduling information in various systems. Reminds patients of scheduled appointments via mail, internet, or telephone. Ensures that patient’s primary care chart is up to date with scheduling information about specialist consults, tests, and procedures managed. Alerts management to trends in appointment availability and appointment date timeliness. Promotes hospital goals towards meaningful use in the electronic medical record on behalf of the referring physician. Documents referral status and all scheduled appointments in appropriate system (electronic medical record) for referral tracking data. Responsible for following up after patient’s consultation, procedure, and/or test to determine if physician has received report; continues to check on status until complete. Serves as Liaison between the provider, practice, patient and specialist providing the service. Communicates Provides appropriate patient clinical information and referral needs to specialist office. Verifies physician’s orders to ensure the accuracy of results and communicates with the patient the guidelines, protocols and location. Assists patients in problem solving potential issues related to navigating the health care system, financial obligations or social barriers (e.g., request interpreters if appropriate, transportation services or prescription assistance). May assume advocate role on the patient’s behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion. Promptly responds to patient’s scheduling requirements (date and time), questions and concerns to ensure patient experience expectations are met or exceeded. Ensures timely appointments are booked; reviews details and expectations about the referral process with patients. Maintains patient confidentiality; complies with HIPAA and compliance guidelines established by Palmetto Health. To ensure the effective and efficient operation of the facility and to create an extraordinary patient, physician and team member experience. Performs other duties as assigned. Supervisory/Management Responsibilities This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Education High School diploma or equivalent Minimum Experience Two (2) years of comparable experience, preferably in a physician front office to include patient registration and/or electronic scheduling and the authorization/precertification process. Other Required Experience Must have excellent customer service skills and a sincere desire to make every patient and their family feel safe, welcomed and appreciated. Excellent oral and written communication skills and interpersonal phone skills. Knowledge of various health insurance companies. Knowledge of medical terminology, CPT and Diagnosis Coding, insurance verification and updates, and the authorization/precertification process. Knowledge of Microsoft office products. Must pass data entry test 85 kst. with 90% accuracy. Work Shift Day (United States of America) Location 5900 Garners Ferry Rd Columbia Facility 3306 Family Medicine 5900 Garners Ferry Department 33061000 Family Medicine 5900 Garners Ferry-Practice Operations Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health. Prisma Health is the largest not-for-profit health organization in South Carolina, serving more than 1.2 million patients annually. Our 32,000 team members are dedicated to supporting the health and well-being of you and your family. Our promise is to: Inspire health. Serve with compassion. Be the difference.
  • 17 Days Ago

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Referral Specialist-Dillon, SC(REFERRAL EXPERIENCE REQUIRED)
  • CareSouth Carolina
  • Hartsville, SC FULL_TIME
  • Job Description: The Referral Specialist is responsible for processing referral requests following CareSouth Carolina guidelines and for providing courteous and professional assistance to patients and...
  • Just Posted

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Referral Specialist-Hartsville, SC(REFERRAL EXPERIENCE REQUIRED)
  • CareSouth Carolina
  • Hartsville, SC FULL_TIME
  • Job Description: The Referral Specialist is responsible for processing referral requests following CareSouth Carolina guidelines and for providing courteous and professional assistance to patients and...
  • 8 Days Ago

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Counseling Testing and Referral Specialist
  • PALSS
  • Columbia, SC FULL_TIME
  • POSITION DESCRIPTION Counseling, Testing & Referral Services Specialist (As assigned to SC DHEC – Prevention/EHE) QUALIFICATIONS: Minimum of 1 year experience (paid or volunteer) in counseling, testin...
  • 3 Days Ago

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Referral Management Specialist
  • MUSC
  • Lancaster, SC FULL_TIME
  • Job Description Summary Obtains and processes signed physician orders/referrals to ensure accurate clinical documentation for care delivery, specialty and outpatient ancillary referrals. In addition, ...
  • 3 Days Ago

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Referral Management Specialist - Orangeburg
  • MUSC
  • Orangeburg, SC FULL_TIME
  • Job Description Summary Job Description Summary Under general supervision, the Referral Management Specialist I serves as the initial point of contact for individuals and referring physicians seeking ...
  • 3 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

South Carolina (/ˌkærəˈlaɪnə/ (listen)) is a state in the Southeastern United States and the easternmost of the Deep South. It is bordered to the north by North Carolina, to the southeast by the Atlantic Ocean, and to the southwest by Georgia across the Savannah River. South Carolina became the eighth state to ratify the U.S. Constitution on May 23, 1788. South Carolina became the first state to vote in favor of secession from the Union on December 20, 1860. After the American Civil War, it was readmitted into the United States on June 25, 1868. South Carolina is the 40th most extensive and 23...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Referral Specialist jobs
$37,832 to $46,540

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