Healthcare- Referral Specialist

Job DescriptionJob Description

URGENTLY HIRING

The Referral Specialist plays an integral role ensuring patients receive timely and efficient access to necessary medical services. You will coordinate with healthcare providers, insurance companies, and patients. This position requires a meticulous attention to detail and a strong commitment to patient care.

Referral Specialist Job Duties:

• Position will be on-site at facility.
• Process patient referrals from healthcare providers ensuring timely scheduling and/or pre-registration.
• Maintain and update patient records with demographic, insurance, authorization and referral information.
• Facilitate the resolution of any insurance coverage discrepancies or authorization issues related to the referral process.
• Scheduling, rescheduling, and canceling patient appointments as required.
• Confirming patient appointments.
• Courteously receiving incoming telephone calls and taking messages as needed.
• Explaining financial requirements and obligations to patients and entering payments into the practice management system.
• Scheduling referral appointments and follow-ups.
• Verifying insurance details and informing patients of un-covered fees.
• Providing a great patient experience.

Requirements:

• High school diploma or GED.
• Post high school education is advantageous.
• Experience working in a medical office or hospital facility setting, preferred.
• Prior call center experience, preferred.
• Working knowledge of medical terminology and medical insurance plans.
• The ability to type fast and accurately.
• Excellent communication and organizational skills.
• Good telephone etiquette.

Company DescriptionVMG s a network of revenue cycle professionals, the majority of whom are at a Senior & Executive Level. Our healthcare professionals, with an average of 20 years’ experience in the industry, understand the unique nuances and requirements of healthcare organizations. VMG’s “hands-on” professionals expand leadership teams to help direct strategic initiatives, manage system design and build, and implementation efforts. We assess situations, chart a strategy and lead the achievement of results. Because we are “operators”, we know what it takes to execute and achieve results. VMG healthcare experts have supported client initiatives across the country.

Our core competencies include building interpersonal relationships, communication, strong finance and business acumen, clinical knowledge, collaboration and team building, changes in management, and quality improvement. VMG’s reputation for promoting the vision of the organization, listening and responding to barriers of achievement, providing job training to instill confidence in employees, training leaders and managers to consistently reinforce the commitment to the mission and negotiating goals amongst internal departments is unparalleled. We conduct all negotiations openly to show respect for all participants and a clear commitment to the scope of the project.

Seasoned Operators – We have been in your seat; we’ve been tested before. We have broad exposure to the industry, and we bring to the table all Senior Level consultants, of similarly sized healthcare systems who have worked successfully and creatively through similar challenges.

Team-driven Structure – Each member of the team has led other teams and works individually and collectively to leverage relevant expertise, insight and perspectives to measurably improve operations, assure execution, and tee up strategy. Our core crew can help to balance the stress of your team in tackling multiple projects at the same time.

VMG Solutions – We bring industry best practices, built and delivered by experienced experts and tailored uniquely to individual clients, resulting in greater insights and better results at an economical cost.

VMG provides its clients with end to end revenue cycle consulting and expertise designed to supplement their internal business operations and/or their designated clients with the following – but not limited to – consulting functions:

Hospital Services

Revenue Cycle Assessments Training (PAS Services and or PFS Services)
Revenue Cycle Technology Utilization Review – for existing technologies as to functionality capability with gap analysis, plus recommendations for new technologies
Implementation Project Managers for new technologies – On-site Off-site support
Interim Expert Staffing Resources
Coding Audits and or Coding Advice
MAC / RAC Audits
Utilization Review and 2 Midnight Inpatient Admission Guidance

Physicians

Physician Billing and Follow-up Services
Denial Management
Patient Access Consulting
Practice Management/EMR Conversion Assistance
Credentialing Services
Enrolling Payors to Clearinghouse for Both Eligibility Claim Submission

Technology / Software Solution Services

Revenue Cycle Technology Utilization Review at Client Sites
Implementation & Post Implementation Support
Technology and Revenue Cycle Training

Full Revenue Cycle Service consulting specialized within Patient Access & Patient Financial Services including scheduling services, financial clearance / eligibility verification services, authorization management, point of service collection techniques, patient flows from check-in through the whole revenue cycle, charge capture & entry, coding, credentialing, billing services, denial management, and overall support to ensure industry best practices are implemented and established. Review and provide education regarding quality metrics, assisting with organizational development, such as policies & procedures redesign, and regulatory compliance measures.

Revenue Cycle Assessments: to establish current performance status; identify opportunities for improvements; provide a gap analysis of current workflows within the client’s operations; development and redesign of new workflows with utilizing the functionality of technologies; provide recommendations of improvements with detail timeline; and provide comprehensive training for both new workflows and implementation support for staff; plus will provide post “Go Live” review to ensure new solutions are fully transitioned and sustainable.

Implementation Project Managing Services of Technologies and Revenue Cycle Improvement Initiatives:

VMG will facilitate meetings with all Revenue Cycle Department leads in order to create a future state process flow that optimizes the meaningfulness of each application (existing or new) to streamline processes. We assist with development of a work plan associated with the IT integration plan and project management of the above-mentioned work plan to ensure that all parties complete items necessary in order to achieve a successful implementation. Our staff participates in comprehensive and regular communication to provide status updates of all efforts, plus communicate progress to the stakeholders of defined said project. We also engage and participate with other resource Vendors whose technologies or workflows are to or can impact the integration of the technology solution(s) to ensure alignment of goals, to ensure each entity is progressing with their action items as needed for a successful implementation, and to report any areas that may create delays to stakeholders of the project.

VMG executives and staff have expertise in appropriate management shifts and cultural transformation steps. We develop work standards, key performance indicators, industry compliance standards, and competency standards for staff. We ensure that comprehensive training (“Elbow Time”) is provided with one on one instruction and guidance for each staff member using the new technologies, workflows, and policies & procedures, plus any compliance reinforcement as needed. We will provide client administrators with competency and alignment evaluations for each staff member.

Expert Staffing: VMG has expert resources for Interim PAS or PFS Leadership roles and or Revenue Cycle Support Services. Typical projects include resources to Work Legacy A/R and or assist with aging AR clean-up projects. We also provide resources to work denials and or an oversight managing perspective, which would include trending, identifying root causes, and providing solutions to decrease denials.Company DescriptionVMG s a network of revenue cycle professionals, the majority of whom are at a Senior & Executive Level. Our healthcare professionals, with an average of 20 years’ experience in the industry, understand the unique nuances and requirements of healthcare organizations. VMG’s “hands-on” professionals expand leadership teams to help direct strategic initiatives, manage system design and build, and implementation efforts. We assess situations, chart a strategy and lead the achievement of results. Because we are “operators”, we know what it takes to execute and achieve results. VMG healthcare experts have supported client initiatives across the country.\r
\r
Our core competencies include building interpersonal relationships, communication, strong finance and business acumen, clinical knowledge, collaboration and team building, changes in management, and quality improvement. VMG’s reputation for promoting the vision of the organization, listening and responding to barriers of achievement, providing job training to instill confidence in employees, training leaders and managers to consistently reinforce the commitment to the mission and negotiating goals amongst internal departments is unparalleled. We conduct all negotiations openly to show respect for all participants and a clear commitment to the scope of the project.\r
\r
Seasoned Operators – We have been in your seat; we’ve been tested before. We have broad exposure to the industry, and we bring to the table all Senior Level consultants, of similarly sized healthcare systems who have worked successfully and creatively through similar challenges.\r
\r
Team-driven Structure – Each member of the team has led other teams and works individually and collectively to leverage relevant expertise, insight and perspectives to measurably improve operations, assure execution, and tee up strategy. Our core crew can help to balance the stress of your team in tackling multiple projects at the same time.\r
\r
VMG Solutions – We bring industry best practices, built and delivered by experienced experts and tailored uniquely to individual clients, resulting in greater insights and better results at an economical cost.\r
\r
VMG provides its clients with end to end revenue cycle consulting and expertise designed to supplement their internal business operations and/or their designated clients with the following – but not limited to – consulting functions:\r
\r
\r
Hospital Services\r
\r
Revenue Cycle Assessments Training (PAS Services and or PFS Services)\r
Revenue Cycle Technology Utilization Review – for existing technologies as to functionality capability with gap analysis, plus recommendations for new technologies\r
Implementation Project Managers for new technologies – On-site Off-site support\r
Interim Expert Staffing Resources\r
Coding Audits and or Coding Advice\r
MAC / RAC Audits\r
Utilization Review and 2 Midnight Inpatient Admission Guidance\r
\r
Physicians\r
\r
Physician Billing and Follow-up Services\r
Denial Management\r
Patient Access Consulting\r
Practice Management/EMR Conversion Assistance\r
Credentialing Services\r
Enrolling Payors to Clearinghouse for Both Eligibility Claim Submission\r
\r
Technology / Software Solution Services\r
\r
Revenue Cycle Technology Utilization Review at Client Sites\r
Implementation & Post Implementation Support\r
Technology and Revenue Cycle Training\r
\r
Full Revenue Cycle Service consulting specialized within Patient Access & Patient Financial Services including scheduling services, financial clearance / eligibility verification services, authorization management, point of service collection techniques, patient flows from check-in through the whole revenue cycle, charge capture & entry, coding, credentialing, billing services, denial management, and overall support to ensure industry best practices are implemented and established. Review and provide education regarding quality metrics, assisting with organizational development, such as policies & procedures redesign, and regulatory compliance measures.\r
\r
Revenue Cycle Assessments: to establish current performance status; identify opportunities for improvements; provide a gap analysis of current workflows within the client’s operations; development and redesign of new workflows with utilizing the functionality of technologies; provide recommendations of improvements with detail timeline; and provide comprehensive training for both new workflows and implementation support for staff; plus will provide post “Go Live” review to ensure new solutions are fully transitioned and sustainable.\r
\r
Implementation Project Managing Services of Technologies and Revenue Cycle Improvement Initiatives:\r
\r
VMG will facilitate meetings with all Revenue Cycle Department leads in order to create a future state process flow that optimizes the meaningfulness of each application (existing or new) to streamline processes. We assist with development of a work plan associated with the IT integration plan and project management of the above-mentioned work plan to ensure that all parties complete items necessary in order to achieve a successful implementation. Our staff participates in comprehensive and regular communication to provide status updates of all efforts, plus communicate progress to the stakeholders of defined said project. We also engage and participate with other resource Vendors whose technologies or workflows are to or can impact the integration of the technology solution(s) to ensure alignment of goals, to ensure each entity is progressing with their action items as needed for a successful implementation, and to report any areas that may create delays to stakeholders of the project.\r
\r
VMG executives and staff have expertise in appropriate management shifts and cultural transformation steps. We develop work standards, key performance indicators, industry compliance standards, and competency standards for staff. We ensure that comprehensive training (“Elbow Time”) is provided with one on one instruction and guidance for each staff member using the new technologies, workflows, and policies & procedures, plus any compliance reinforcement as needed. We will provide client administrators with competency and alignment evaluations for each staff member.\r
\r
Expert Staffing: VMG has expert resources for Interim PAS or PFS Leadership roles and or Revenue Cycle Support Services. Typical projects include resources to Work Legacy A/R and or assist with aging AR clean-up projects. We also provide resources to work denials and or an oversight managing perspective, which would include trending, identifying root causes, and providing solutions to decrease denials.

---