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HMO Referral Specialist
2 months ago
USA Clinics Group is expanding and is in search of an HMO Referral Specialist to join our dedicated team.
Are you passionate about enhancing patient care? Do you possess a professional demeanor, are results-driven, and excel at managing multiple tasks? If so, this position may be the perfect fit for you.
The HMO Referral Specialist will oversee the coordination and management of all patient referrals for specialized medical services within a busy healthcare environment.
Key Responsibilities
- Engage with Primary Care Provider (PCP) offices to secure system-generated referrals through phone or fax communication.
- Evaluate all referrals for eligibility, precision, and completeness.
- Monitor and manage HMO referrals by inputting data into the electronic system.
- Serve as a communication bridge between patients and their Primary Care Physicians to ensure timely referrals.
- Execute additional related tasks as required.
Qualifications
- High School diploma or equivalent, with a minimum of three years of experience in medical referral authorization within the healthcare sector, strongly preferred.
- Experience in processing referrals for HMO, preferred.
- Proficiency in Microsoft Office Suite (Outlook, Excel, Word) and familiarity with Electronic Medical Records (EMR), preferred.
- Excellent communication skills, ability to thrive in a high-volume patient setting, goal-oriented mindset, capability to prioritize tasks and meet deadlines, keen attention to detail, self-motivated, and commitment to service excellence.
- Ability to effectively manage multiple tasks simultaneously.
- Adherence to quality improvement principles with a strong emphasis on job accuracy, efficiency, and reliability.
- Understanding of HIPAA regulations.
- Maintain strict confidentiality regarding all patient, corporate, financial, and proprietary information.
Employee Benefits
- Health Insurance
- Dental Coverage
- Vision Insurance
- 401(k) Plan
- Paid Time Off (PTO)
