Healthcare Referral Specialist

3 weeks ago


Beverly Hills, California, United States ThreePDS Inc. Full time
About the Role:

The Referral Coordinator is responsible for ensuring seamless administrative processing of patient personal and insurance information for a group of dialysis clinics.

This individual will work closely with internal and remote teams, possessing strong time management skills and the ability to complete assigned job duties with applicable supervisory direction.

Key Responsibilities:
  • Process new patient referrals through the Central Registration System (CRS), ensuring accuracy of patient personal and insurance information.
  • Complete insurance benefit verifications via phone or online verification tools to confirm patient benefits and determine acceptance to the clinic.
  • Work with clinic staff to ensure proper documentation for patient verifications and obtain patient and/or representative signatures on admission documentation as needed.
  • Act as the first point of contact for patient benefit or network status questions, escalating difficult conversations as necessary.
  • Ensure completeness and accuracy of patient accounts in the billing system, QMS.
  • Resolve billing rejections related to patient demographic information, working with the patient and/or payer for resolution if necessary.
  • Educate patients on financial responsibility while traveling internationally and draft corresponding agreements for signature.
  • Initiate requests for authorization as needed based on insurance requirements and clinic network status.
  • Complete and maintain region and/or clinic-specific reports.
  • Ensure compliance with CMS coordination of benefits rules and maintain confidentiality of all data, including patient, employee, and operational data.
Requirements:
  • Bachelor's degree required.
  • 2 years of experience in a similar administrative setting (referral coordinator/benefits coordinator/admissions coordinator) required.
  • Must be willing and serious about going direct after the 13-week travel assignment.


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