Referral Specialist jobs in Canton, MI

Referral Specialist processes insurance pre-verification for hospital admissions or specialty service office visits. Gathers pertinent information from patients, insurance carriers, financial counselors, and other staff to confirm the patient's financial obligations for services. Being a Referral Specialist acts as a liaison between hospitals, clinical staff, health plans, providers, and patients to process referrals. Verifies insurance coverage and obtains required authorizations. Additionally, Referral Specialist resolves pre-certification, registration, and case-related issues. Documents referrals, communications, actions, and other data in an information system. Generates and distributes all applicable forms, notifications, and paperwork. May require an associate degree. Typically reports to a supervisor. The Referral Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Referral Specialist typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)

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Referral Specialist
  • Trinity Health - IHA
  • Ann Arbor, MI FULL_TIME
  • POSITION DESCRIPTION:

    This position is responsible for all aspects of the referral process which may vary depending on practice/department specialty.  May perform Medical Receptionist duties as necessary.

     

     

    ESSENTIAL JOB FUNCTIONS:

    1.      Educates patients and staff with pertinent referral and insurance information.

    2.      Generates referral information for physicians, patients, and health plans.

    3.      Acts as a liaison among providers, patients, and health plan administrators.

    4.      Relays clinical information to health plan case managers for special procedure pre-certification and out-of-plan or out-of-network referrals; monitors authorizations or denials and follows up as necessary.

    5.      Communicates referral status to patients and physicians; ensures that referrals have been processed accurately and in a timely manner to coincide with patient treatment plan.

    6.      Assists patients in scheduling appointments with specialists, resolving billing discrepancies and any other referral issues.

    7.      Supports other offices, attends required meetings and training, and participates in committees as requested.

    8.      May perform Medical Reception duties as necessary.

    9.      Assists with special projects and assumes additional duties as assigned.

     

     

    ORGANIZATIONAL EXPECTATIONS:

    1.      Creates a positive, professional, service-oriented work environment for staff, patients and family members by supporting the IHA CARES mission and core values statement

    2.      Must be able to work effectively as a member of the reception team.

    3.      Successfully completes IHA's "The Customer" training and adheres to IHA's standard of promptly providing a high level of service and respect to internal or external customers.

    4.      Maintains knowledge of and complies with IHA standards, policies and procedures, including IHA's Employee Handbook.

    5.      Maintains complete knowledge of office services and in the use of all relevant office equipment, computer, and manual systems

    6.      Maintains strict patient and employee confidentiality in compliance with IHA and HIPAA guidelines

    7.      Serves as a role model, by demonstrating exceptional ability and willingness to take on new and additional responsibilities.  Embraces new ideas and respects cultural differences.

    8.      Uses resources efficiently.

    9.      Monitors, organizes and keeps work area and waiting room neat. 

     

    MEASURED BY:

    Performance that meets or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position.

     

    ESSENTIAL QUALIFICATIONS:

    EDUCATION:  Undergraduate degree or Associate's degree in health care or a related field and specialized training or equivalent combination of education and experience.

    CREDENTIALS/LICENSURE:  None

    MINIMUM EXPERIENCE:  4 years' experience with insurance referrals, prior authorization or other relevant medical office experience.

     

     

    POSITION REQUIREMENTS (ABILITIES & SKILLS):

    1.      Knowledge of medical terminology and procedures at the level needed to perform responsibilities.

    2.      Proficient knowledge of major health plans and insurance processes.

    3.      Excellent written (legible), verbal and face-to-face communication skills, including ability to effectively explain relevant insurance information to patients, as well as communicate with insurance plans and internal customers. Proper phone etiquette.

    4.      Proficient/knowledgeable in patient care procedures and organizational policies related to position responsibilities.

    5.      Service-oriented; responsive to customer needs and courteous in approach.

    6.      Proficient in operating a standard desktop and Windows-based computer system, including but not limited to, electronic medical records, NextGen, Microsoft Word /Excel/Outlook, intranet and computer navigation.  

    7.      Ability to compute mathematical calculations.

    8.      Ability to work independently and collaboratively in a team-oriented environment; professional and friendly demeanor.

    9.      Ability to work effectively with various levels of organizational members and diverse populations including IHA staff, patients, family members, vendors, outside customers and couriers.

    10.    Ability to cross-train in other areas of practice in order to achieve smooth flow of all operations.

    11.    Good organizational and time management skills to effectively juggle multiple priorities and time constraints.

    12.    Ability to exercise sound judgment and problem-solving skills.

    13.    Ability to handle patient and organizational information in a confidential manner.

    14.    Ability to travel to other office/practice sites and meeting and training locations.

    15.    Successful completion of IHA competency-based program within introductory and training period. 

     

     

    MINIMUM PHYSICAL EXPECTATIONS:

    1.      Physical activity that often requires keyboarding, filing and phone work.

    2.      Physical activity that often requires extensive time working on a computer.

    3.      Physical activity that sometimes requires walking, standing, bending, stooping, reaching, and/or twisting.       

    4.      Physical activity that sometimes requires lifting, pushing and/or pulling under 30 lbs.

    5.      Specific vision abilities required include close vision, depth perception, peripheral vision and the ability to adjust and focus. 

    6.      Manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment.

    7.      Must hear and speak well enough to conduct business over the telephone or face to face for long periods of time in English.

     

     

    MINIMUM ENVIRONMENTAL EXPECTATIONS:

    This job operates in a typical office environment with some exposure to contagious diseases/viruses.  It requires significant interaction with people (many of whom are scared, hurt and/or ill) which can be stressful and result in competing priorities.

     

  • 18 Days Ago

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Information & Referral Specialist
  • LifeWays
  • Jackson, MI FULL_TIME
  • General Summary: Under the direction of the 2-1-1 Program Supervisor along with the day to day support from the Lead Information and Referral Specialist, the position of Information & Referral Special...
  • 2 Days Ago

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Full-Time Medical Receptionist/Referral Specialist
  • Provider Staffing Inc. for Ascension Medical Group Genesys Providers
  • Linden, MI FULL_TIME
  • On behalf of Ascension Medical Group Genesys, Providers Staffing, Inc., is hiring a full-time Medical Receptionist/Referral Specialist for the Linden office. This person must have strong front desk sk...
  • 20 Days Ago

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Landscape Lighting Specialist Apprentice
  • Landscape Lighting Specialist
  • Ann Arbor, MI FULL_TIME
  • Do you dream about working outdoors? Are you ready to experience the joy of artistically illuminating beautiful Michigan landscapes? About Us: Landscape Lighting Specialist provides thoughtfully desig...
  • 12 Days Ago

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Landscape Lighting Technician Assistant
  • Landscape Lighting Specialist
  • Ann Arbor, MI FULL_TIME
  • Do you dream about working outdoors? Are you ready to experience the joy of artistically illuminating beautiful Michigan landscapes? About Us: Landscape Lighting Specialist provides thoughtfully desig...
  • 12 Days Ago

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Referral coordinator
  • VirtualVocations
  • Jackson, MI FULL_TIME
  • A company is looking for a Referrals Coordinator 2 to process referrals from Military Treatment Facilities (MTFs) and civilian providers. Key Responsibilities : Recognizes sensitive diagnoses and refe...
  • 28 Days Ago

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0 Referral Specialist jobs found in Canton, MI area

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Subject Matter Expert/Proposal Writer
  • Donatech Corporation
  • Troy, MI
  • Position would require the candidate to be a W2 employee of Donatech. US Citizenship Required. This position is responsi...
  • 3/28/2024 12:00:00 AM

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Test Specialist Consultant/Expert
  • V2Soft Inc.
  • Dearborn, MI
  • V2Soft (www.v2soft.com) is a global company, headquartered out of Bloomfield Hills, Michigan, with locations in Mexico, ...
  • 3/28/2024 12:00:00 AM

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Subject Matter Expert IRS Special Enrollment Examination
  • Prometric
  • Detroit, MI
  • Job Description Job Description Prometric, a global provider of technology-enabled testing and assessment solutions, has...
  • 3/27/2024 12:00:00 AM

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Architect Consultant/Expert
  • HonorVet Technologies
  • Allen Park, MI
  • Position: Architect Consultant/Expert Location: Allen Park,MI 48101 Duration: 12 Months Position Description: Develop te...
  • 3/25/2024 12:00:00 AM

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Sleep Expert - Sales
  • Mattress Firm
  • Novi, MI
  • Is your current job a nightmare? Make it a dream job at Mattress Firm! Join Mattress Firm as a Sleep Expert and have the...
  • 3/25/2024 12:00:00 AM

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Sleep Expert - Sales
  • Mattress Firm
  • Wixom, MI
  • Is your current job a nightmare? Make it a dream job at Mattress Firm! Join Mattress Firm as a Sleep Expert and have the...
  • 3/25/2024 12:00:00 AM

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Sleep Expert - Sales
  • Mattress Firm
  • South Lyon, MI
  • Is your current job a nightmare? Make it a dream job at Mattress Firm! Join Mattress Firm as a Sleep Expert and have the...
  • 3/25/2024 12:00:00 AM

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Sleep Expert - Sales>
  • Mattress Firm
  • Lake Orion, MI
  • Mattress Firm - JR-P0051667 [Sales Associate / Team Member] As a Sleep Expert at Mattress Firm, you'll: Elevate and enha...
  • 3/24/2024 12:00:00 AM

Canton, officially the Charter Township of Canton, is a charter township of Wayne County in the U.S. state of Michigan. It is located about 8 miles (13 km) west of the city limits of Detroit and 8 miles (13 km) east of the city limits of Ann Arbor. As of the 2010 census, the township had a population of 90,173, making it Michigan's second largest township and eleventh largest community. Canton is ranked as 96th highest-income place in the United States with a population of 50,000 or more. Canton Township is also consistently ranked as one of the safest cities in the United States, as well as i...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Referral Specialist jobs
$41,286 to $50,789
Canton, Michigan area prices
were up 1.3% from a year ago

Referral Specialist in Terre Haute, IN
This position serves as the centralized intake for all internal referrals to core service programs.
December 12, 2019
Referral Specialist in Albany, NY
The Information and Referral Specialist 1 is the entry level classification which gathers information on community resources and utilizes a broad knowledge of the community resource network to make appropriate referrals to service providers.
December 01, 2019
Referral Specialist in Florence, AL
As a Referral Specialist you will execute patient insurance referrals, consultations, and diagnostic procedures relating to Kadlec Clinic.
January 14, 2020