Referral Specialist ensures patients have been cleared for specialty service office visits. Resolves pre-certification, registration and case-related concerns prior to a patient's appointment. Being a Referral Specialist gathers pertinent information from insurance carriers, financial counselors, and other ancillary staff to make certain the patient's financial obligations for services provided. Provides support to clinical staff in order to facilitate the administrative components of clinical referrals for various services. Additionally, Referral Specialist acts as a liaison between hospitals, physicians, health plans, vendors, and patients, or other referral sources. Verifies insurance coverage and obtains authorizations if needed from insurance coverage. Enters referrals and documents communications, actions, and other data in an information system. Requires an associate degree or its equivalent. Typically reports to a supervisor or manager. The Referral Specialist gains or has attained full proficiency in a specific area of discipline. Works under moderate supervision. To be a Referral Specialist typically requires 1-3 years of related experience. (Copyright 2020 Salary.com)
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