What are the responsibilities and job description for the Referral Specialist - Georgetown position at Neighborcare Health?
Purpose:
The Referral Specialist is responsible for receiving, analyzing and processing all referrals and authorization requests for patients according to specific insurance requirements. The Referral Specialist ensures patients have been cleared for specialty service office visits and certain procedures. The Referral Specialist will provide support to clinical staff in order to facilitate the administrative components of clinical referrals for various services and work closely with the Coding Team to ensure billing codes are accurate on all referrals and work with the Insurance Verification Team to ensure accurate and verified insurance prior to submitting the referral and/or prior authorization. Coordinate patient care to specialists. Verifying patient insurance and confirming patient benefits. Obtain prior authorizations.
This position is eligible for the Staff Referral Program. Neighborcare Health offers a robust benefit package including health insurance, paid time off, holiday pay, retirement pet insurance, and more!
Primary Responsibilities:
- Processes physician referral orders (EKG’s, CT, MRI, etc.) using EHR system. This includes obtaining any authorization needed. Accurately enters notes into EHR regarding letters or correspondence from insurance companies regarding insurance authorization or other referral notifications.
- Demonstrates and applies knowledge of medical terminology. Communicates the results of the authorization request with the patient. Processes physician referral orders (EMG, CT, MRI, etc.) using EHR system. This includes obtaining any authorization needed in a timely manner.
- Applies knowledge ICD-10 and CPT coding. Answering incoming patient and insurance company phone calls as received. Maintains up-to-date knowledge of insurance plans and billing rules. Perform other duties as assigned within job qualifications.
Required qualifications for this position include:
- Associate’s degree (AA) or equivalent from a two-year college or technical school
Preferred qualifications for this position include:
- 2-years experience in a medical setting; or equivalent combination of education and experience.
Our Mission
The mission of Neighborcare Health is to provide comprehensive health care to families and individuals who have difficulty accessing care; respond with sensitivity to the needs of our culturally diverse patients; and advocate and work with others to improve the overall health status of the communities we serve.
About us
For 50 years, Neighborcare Health has been caring for our neighbors with essential medical and dental care, counseling, outreach, health education and more in Seattle, Vashon, and our newest dental clinic in Olympia! Our purpose is to improve health by engaging, educating, and empowering people in the communities we serve. We are looking to hire the best talent to support our culturally diverse workplace and community.
Union: Yes
Full job description will be provided during the interview process.
