Referral Specialist Gastroenterology/Urology

2 days ago

Victoria, United States Citizens Medical Center Full time

Description

JOB SUMMARY

The Referral Specialist coordinates insurance referrals for Citizens Medical Professional patients, ensuring coverage meets the standards of order and referral criteria. The position provides insurance verification and authorization for insured patients. Uses phone and online resources and external phone inquiries regarding patient's benefits, procedures, and financial obligations as warranted. The Referral Specialist may also perform Patient Service Specialist responsibilities, including greeting patients, answering, and directing incoming phone calls, and checking patients in and out accurately and efficiently.

Job Specific:

  1. Responsible for oversight of the insurance referral/authorization process to include timely scheduling and complete processing of eligibility and benefit verification, initial and ongoing referral/authorization requests, and accurate entry of relation information in designated software system. (EF)
  2. Maintain policies and procedures to ensure timely communication of referral and authorization status to multiple locations as needed, providing necessary information to facilitate decision making for patient scheduling and visit utilization coverage. (EF)
  3. Maintains efficient tracking of all pending referrals to ensure timely scheduling and avoid loss of revenue. (EF)
  4. Performs routine review of outstanding requests and redirects workload as warranted.
  5. Accurately identifying required clinical information utilizing current procedural terminology (CPT) and International Classification Diseases and Health Care Procedure Coding System (ICD-10) to ensure minimal delay of authorization approval. (EF)
  6. Demonstrate ability to solve problems independently and perform at optimal level.
Patient Services Specialist Role:
  1. Greets patients professionally and politely at check-in/check-out windows. (EF)
  2. Promptly answers and directs all incoming phone calls to the appropriate area professionally and politely by identifying our organization and self clearly and pleasantly. (EF)
  3. Checks patients in and out accurately and efficiently. (EF)
  4. Verifies all information to be complete and update as needed - makes changes as needed.
  5. Obtains insurance card and scans into EMR.
  6. Adds / updates financial group to correspond with payer type. (EF)
  7. Correctly enters insurance carrier into patient's demographics. (EF)
  8. Prepares charts for Out-of-Town Clinics as per clinic procedure. (EF)
  9. Prints Encounter tickets to nurses' printer. (EF)
  10. Confirms appointments and documents response in EMR. (EF)
  11. Logs echoes and holter from outside entities; delivers to physician for reading as per clinic procedure. (EF)
  12. Collects outstanding balances, co-pays and co-insurances due at time of check out. (EF)
  13. Reconciles cash drawer using designated format, and signs along with clinic manager.
Hospital:
  1. Adheres to organization-wide and other applicable policies and procedures.
  2. Day-to-day performance complies with the hospital's Service Excellence Behavioral Expectations.
  3. Performs within the prescribed limits of the hospital's Ethics, Compliance and Confidentiality Program guidelines.
  4. Performs within professional Scope of Practice at all times.

Other Duties As Assigned:

Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time.

Minimum Requirements

EDUCATIONAL REQUIREMENTS

Required: High School Diploma or GED.

EXPERIENCE

Required: One-year medical office pre-authorization and referral experience. Knowledge of payer guidelines and regulatory requirements, including third party procedures and practices required. Working knowledge of medical terminology, good human relations, and analytical skills required, ability to use computerized electronic medical record software.

Preferred: Two years medical office pre-authorization and referral experience.

SPECIAL SKILLS AND ABILITIES

Required: Excellent communication, organizational and task prioritization skills.

Preferred: Excellent typing and computer skills, including work and excel. Ability to relate with people of diverse backgrounds, provide excellent customer service and solutions to issues. Understands Medical terminology, and knowledge of current procedure terminology (CPT), International Classification Diseases and Health Care Procedure Coding System (ICD-10), computer knowledge of Excel and Word.

COMPANY PROFILE

Citizens Medical Center is a not-for-profit, community hospital known for compassionate patient care, clinical expertise, and bringing advanced medical services to the South Texas region since 1956. Today, Citizens is a 317-bed acute care hospital with over 1,200 employees. Voted "Best of the Best" hospital in Victoria for 14 consecutive years, Citizens Medical Center is a level III Trauma Center, with a newly renovated 24/7 Emergency Department that includes an onsite medical helicopter. Citizens has a comprehensive Community Cancer Program that includes two linear accelerators and HDR brachytherapy. Citizens is recognized for its outstanding cardiology program which includes a nationally accredited Chest Pain Center and is a Primary Stroke Center. Citizens also includes a comprehensive, accredited Bariatric Surgery program, Birth Center with labor and delivery, an imaging and surgery center, sleep study center, state-of-the-art rehabilitation and fitness center, urology center and daVinci robotics minimally invasive surgery options, a home health agency, and has a long history of providing continuing education for healthcare providers and the community.

Citizens Medical Center is looking for employees who actively demonstrate service excellence by exemplifying our iCare values. If you are someone who displays respect and enthusiasm for patients, visitors, and coworkers while consistently upholding the hospital's commitment to providing outstanding outcomes, service excellence, and fiscal responsibility, then you could be a good fit for the CMC team

BENEFIT OFFERINGS

Health
  • Medical, Dental, Vision
  • STD, LTD Disability
  • Supplemental Life, AD&D
  • Flexible Spending (FSA)
  • Employer paid life insurance and short term disability
Retirement/Investment
  • Defined Benefit Pension Plan
  • 457(b) Deferred Compensation
Well-Being Benefits
  • Paid Time Off
  • Sick leave, Bereavement leave, Jury Duty/Witness Service
  • Tuition Reimbursement
  • Hospital-paid & administered annual immunizations
  • HealthPlex (gym) membership discount
  • YMCA partnership discount for childcare
  • Employee Assistance Programs


Job Preview Video

  • Referral Specialist Gastroenterology/Urology

    2 days ago

    Victoria, United States Citizens Medical Center Full time

    Description JOB SUMMARY The Referral Specialist coordinates insurance referrals for Citizens Medical Professional patients, ensuring coverage meets the standards of order and referral criteria. The position provides insurance verification and authorization for insured patients. Uses phone and online resources and external phone inquiries regarding patient's...

  • Urology Specialist

    7 days ago

    Victoria, Texas, United States Sumo Medical Staffing Full time

    Job SummaryWe are seeking a highly skilled and experienced Urology Specialist to join our team at Sumo Medical Staffing. This is a great opportunity for a physician to work as a Locum Urologist in Victoria, Texas.About the JobThis locum tenens urology position offers a competitive market rate compensation package, including malpractice insurance, airfare,...

  • Gastroenterology Specialist Physician

    1 week ago

    Victoria, Texas, United States Aya Locums Full time

    Aya Locums offers a lucrative locum tenens gastroenterology opportunity in Victoria, TX. As a highly skilled gastroenterology specialist physician, you will provide top-notch care to patients at an acute care hospital.Job SummaryWe are seeking a board-certified gastroenterologist to join our team for a 13-week assignment. The ideal candidate will have at...

  • Physician Urology Specialist for Clinical Call

    1 month ago

    Victoria, Texas, United States Adelphi Medical Staffing Full time

    About the Role: We are seeking a skilled Physician Urology Specialist to join our team on a locum tenens basis at a hospital in Victoria, TX. As a key member of our clinical staff, you will be responsible for providing high-quality patient care and collaborating with our multidisciplinary team to ensure the best possible outcomes.Key Responsibilities:...

  • Gastroenterology Specialist

    7 days ago

    Victoria, Texas, United States AMN Healthcare Full time

    Gastroenterology Physician Job DescriptionThis is an excellent opportunity for a board-certified Gastroenterology Physician to join our team and contribute to delivering high-quality patient care. As a locum tenens physician, you will be responsible for providing clinical services, collaborating with our medical team, and ensuring the best possible outcomes...

  • Gastroenterology Specialist in Texas Healthcare System

    1 month ago

    Victoria, Texas, United States AMN Healthcare Full time

    About the RoleWe are seeking a skilled Gastroenterologist to join our team in a thriving Texas healthcare system. As a specialist in Gastroenterology, you will have the opportunity to work with a talented team of healthcare professionals and contribute to providing high-quality patient care.Key Responsibilities:Provide medical consultation and treatment to...

  • Urology Physician Specialist

    3 weeks ago

    Victoria, Texas, United States Jackson and Coker Full time

    Opportunity for a Urologist in South TexasAssignment OverviewA urology physician is needed for scheduled clinic and on-call coverage in south Texas. The ideal candidate will have an active and unrestricted Texas license or IMLC, as well as board certification. Additionally, ACLS, BLS, and certifications are required, with fellowship...

  • Urology Specialist Position

    7 days ago

    Victoria, Texas, United States Adelphi Medical Staffing Full time

    **Job Overview:** Adelphi Medical Staffing is seeking a board-certified Urologist to provide coverage at a hospital in Victoria, TX. This is a great opportunity for a physician looking to gain experience in general urology and advanced endoscopic techniques.**Estimated Salary:** Based on industry standards, the estimated annual salary for this position is...

  • Urology Physician

    4 weeks ago

    Victoria, United States Goldfish Medical Staffing Full time

    Locum Tenens Urology Coverage Needed in Texas Begin ASAP - Ongoing Scheduled hours + beeper call (1:1) Weeknight call: 5p-8a, M-F Phone consults per day: 3 Patients per day: 15-20 Inpatient / outpatient mix Goldfish Medical Staffing Extraordinary Dedication to Exceeding Expectations Means Malpractice Insurance with Contractual Guaranteed Tail...

  • Urology Physician

    4 weeks ago

    Victoria, United States SimplyApply Full time

    Locum Tenens Urology Coverage Needed in Texas Begin ASAP - Ongoing Scheduled hours + beeper call (1:1) Weeknight call: 5p-8a, M-F Phone consults per day: 3 Patients per day: 15-20 Inpatient / outpatient mix Goldfish Medical Staffing Extraordinary Dedication to Exceeding Expectations Means Malpractice Insurance with Contractual Guaranteed Tail...

  • Urology Physician Specialist

    3 weeks ago

    Victoria, Texas, United States RecruitWell Full time

    At RecruitWell, we are seeking a skilled Urology Physician to join our team in Victoria, Texas. This is an exciting opportunity for a medical professional who is passionate about delivering high-quality patient care in a dynamic environment.About the RoleWe are looking for a board-certified Urologist with a strong track record of clinical excellence and...

  • Urology Physician Specialist

    1 month ago

    Victoria, Texas, United States Goldfish Medical Staffing Full time

    Goldfish Medical Staffing is seeking an experienced Urology Physician to join their team for locum tenens coverage in Texas. This opportunity offers a stable and rewarding environment, with a competitive salary.About the OpportunityThis full-time position requires immediate start and ongoing commitment. The successful candidate will be responsible for...

  • Gastroenterology Physician Specialist Opportunity

    7 days ago

    Victoria, Texas, United States Curative Full time

    Job OverviewThis is a locum tenens gastroenterology position available in Victoria, TX.The ideal candidate will have experience with routine gastroenterological procedures and be comfortable working in a Level 3 trauma facility.A supportive team including 2 APPs and 1 MA will provide assistance with patient care.

  • Urology Specialist in South Texas

    4 weeks ago

    Victoria, Texas, United States Jackson and Coker Full time

    Job OverviewJackson and Coker is seeking a skilled Urology Physician to provide scheduled clinic and on-call coverage in South Texas.Estimated Salary$250,000 - $350,000 per year.Key ResponsibilitiesThe selected candidate will be responsible for:Providing medical care to patients with urological conditionsPerforming surgeries, including laparoscopic and...

  • Urology Physician

    3 weeks ago

    Victoria, United States RecruitWell Full time

    Locums - Victoria, Texas, Urology Opening (IMLC Accepted)Clinical Role:Do you know someone that might be a good fit for this position? Please ask about our generous referral fees!ASAP - Ongoing NeedClinic and Call Coverage20 minutes call response time requiredAdmissions Required15-20 Patients Per ShiftBeds in department: 3Trauma Level IIIEMR: AthenaHospital...

  • Urology Specialist Position

    3 weeks ago

    Victoria, Texas, United States Integrity Locums Full time

    Job Description:We are seeking a skilled Urology Physician to join our team at Integrity Locums. This position requires a board-certified or board-eligible urologist with expertise in general urology, including adult and pediatric care.Responsibilities:Provide high-quality patient care through outpatient, inpatient, and telehealth servicesSupervise Advanced...

  • Traveling Gastroenterology Physician

    1 week ago

    Victoria, Texas, United States Aya Locums Full time

    Aya Locums invites applications from experienced gastroenterologists for a 13-week locum tenens assignment at an acute care hospital in Victoria, TX. As a gastroenterology specialist physician, you will have the chance to showcase your skills and contribute to the well-being of patients.About the JobThis is a temporary assignment, typically lasting several...

  • Urology Specialist Physician Opportunity in South Texas

    7 days ago

    Victoria, Texas, United States Jackson and Coker Full time

    Urology Locums JobIn South Texas, we are seeking an experienced Urology Physician to provide scheduled clinic and on-call coverage starting as soon as possible.Assignment Details/Requirements:An active and unrestricted Texas license or IMLC is required.Board Certification in Urology is mandatory.Acls, BLS, and Certifications are also required. Fellowship in...

  • Locum Physician

    3 weeks ago

    Victoria, United States Aya Locums Full time

    Aya Locums has an immediate opening for a locum Gastroenterology job in Victoria, TX paying $450/hour - $500/hour. Job Details: Position: Physician Specialty: Gastroenterology Start Date: 03-17-25 Length: 13 weeks Schedule and Coverage: Shift Coverage: Scheduled On Call required Shift Schedule: Standard 5, 8-Hour 08:00 - 16:00 About the Facility: Facility...

  • Gastroenterology Physician

    4 weeks ago

    Victoria, United States RecruitWell Full time

    Locums - Victoria, Texas, Gastroenterology Opening (IMLC Accepted)Clinical Role:Do you know someone that might be a good fit for this position? Please ask about our generous referral fees!ASAP - OngoingClinic and Call CoverageHospital Stroke Certified30 Patients Per Shift3 Beds in FacilitySkills Required:Upper GI Endoscopy (w/Biopsy)Lower GI...