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Referral Specialist

2 months ago

Nashville, United States Matthew Walker Comprehensive Health Center Full time
Job DescriptionJob Description

Matthew Walker Comprehensive Health Center has an exciting opportunity available for a skilled, resourceful, and motivated individual who would like to make a difference in the lives of others in helping a non-for-profit organization fulfill its mission to provide quality health care. Reporting to the PCMH Quality Improvement Manager, the Referral Specialist (RS) will be responsible for the following to include, but not limited to:

· Processing patient referrals in a timely manner and responding to general information inquiries

· Answering a high volume of incoming telephone calls from patients, insurance companies and other healthcare providers

· Ensuring ICD-9 and CPT codes are accurate on referral authorizations prior to submitting them to the insurance company

· Responding to information requests from various parties regarding referrals or other pertinent medical requests for patients

· Ensuring referral requests are processed and documented completely and in a timely manner

· Obtaining prior authorization from insurance carriers and following up to ensure referral appointments are kept by patients

· Working cooperatively with insurance companies, patients, center and administrative staff

· Case coordinating for chronic diseases and preventive care for patients

 

EDUCATION/EXPERIENCE:

High School diploma, or equivalent, is required. College degree or higher education level is preferred. The RS should possess stellar customer service, communication, and organizational skills with an acute attention to detail. Knowledge of and the ability to use an automated call distributor telecommunication system is preferred.