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)
Job Description Summary
The Referral Management Specialist II reports to the Patient Access Scheduling Supervisor. Under general supervision, the Patient Access Specialist position schedules appointments for multiple specialties and primary care physicians in a call center environment utilizing an automated scheduling system. This role serves as expert in all healthcare scheduling/access areas as related to provider specific templates and specialties. This position works closely with departmental, clinical, physicians and division staff to assist potential customers in navigating the system to gain access and referral information for medical care at MUSC. This position triages patient calls according to established algorithms, answering questions, resolving issues and referring to appropriate clinical team for clinical issues as necessary. This role functions as the primary patient advocate between medical team and consumer by coordinating their requests and satisfying needs in one phone call. This positions performs quality data collection of accurate information including demographic, physician, insurance, employment, next of kin, emergency contacts and other miscellaneous information needed to complete the patient’s information. This role displays highest level of customer service, attentiveness, and consideration possible in all areas.Entity
Medical University Hospital Authority (MUHA)Worker Type
EmployeeWorker Sub-Type
RegularCost Center
CC000388 CHS - DDC Clinical (Digestive Disease Center) (ART)Pay Rate Type
HourlyPay Grade
Health-19Scheduled Weekly Hours
40Work Shift
Day (United States of America)Job Description
The Referral Management Specialist II reports to the Patient Access Scheduling Supervisor. Under general supervision, the Patient Access Specialist position schedules appointments for multiple specialties and primary care physicians in a call center environment utilizing an automated scheduling system. This role serves as expert in all healthcare scheduling/access areas as related to provider specific templates and specialties. This position works closely with departmental, clinical, physicians and division staff to assist potential customers in navigating the system to gain access and referral information for medical care at MUSC. This position triages patient calls according to established algorithms, answering questions, resolving issues and referring to appropriate clinical team for clinical issues as necessary. This role functions as the primary patient advocate between medical team and consumer by coordinating their requests and satisfying needs in one phone call. This positions performs quality data collection of accurate information including demographic, physician, insurance, employment, next of kin, emergency contacts and other miscellaneous information needed to complete the patient’s information. This role displays highest level of customer service, attentiveness, and consideration possible in all areas.
Additional Job Description
If you like working with energetic enthusiastic individuals, you will enjoy your career with us!
The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.
Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees
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