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HMO Referral Specialist
2 months ago
Join Our Team as an HMO Referral Specialist
USA Clinics Group is expanding and seeking a dedicated HMO Referral Specialist to enhance our operations.
Are you passionate about improving patient care? If you possess compassion, professionalism, and the ability to manage multiple tasks efficiently, this position may be the perfect fit for you.
Key Responsibilities:
- Communicate with Primary Care Provider (PCP) offices to secure system-generated referrals through phone or fax.
- Evaluate all referrals for eligibility, accuracy, and completeness.
- Monitor and manage HMO referrals by inputting them into our computer system.
- Serve as a liaison between patients and their Primary Care Physicians to ensure timely referrals.
- Perform additional related duties as assigned.
Qualifications:
- A High School diploma or equivalent is required, with a preference for candidates who have three or more years of experience in medical referral authorization within the healthcare sector.
- Experience in processing referrals for HMO is preferred.
- Proficiency in Microsoft Office (Outlook, Excel, and Word) and familiarity with Electronic Medical Records (EMR) is preferred.
Skills:
- Excellent communication skills and the ability to thrive in a high-volume patient environment.
- Results-oriented with strong organizational skills to prioritize tasks and meet deadlines.
- Detail-oriented, self-motivated, and committed to service excellence.
We value a quality improvement philosophy that emphasizes accuracy, efficiency, and reliability in all job functions.
Understanding of HIPAA regulations is essential.
Maintain strict confidentiality regarding all patient, corporate, financial, and proprietary information.
Benefits:
- Health Insurance
- Dental Coverage
- Vision Insurance
- 401k Plan
- Paid Time Off (PTO)
