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 when necessary. Additionally, Referral Specialist documents referrals, communications, actions, and other data in an information management system. Generates and distributes all applicable forms, notifications, and paperwork. Requires a high school diploma. 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)
To work closely with Lana’i Community Health Center (LCHC) patients, families, clinical staff and external organizations to ensure quality patient care by assessing patients’ needs, coordinating services and resources, obtaining referrals, tracking hospitalizations, and monitoring follow-through. LCHC is a patient care, teaching and research organization and also provides workshops, education sessions and outreach – all employees should expect to be involved with these activities tothe extent to which will depend upon their position in the organization.