Contact Center Referral Specialist I
About The Position
The Referral Specialist is the first connection between Intermountain and patients and is responsible to focus on establishing collaborative relationships with patients and fellow caregivers (employees) to deliver the highest level of customer/patient satisfaction. Referral Specialists are responsible for fostering relationships with patients, parents and guardians regarding the patient's care to include ensuring compliance with managed care, commercial insurance, and public insurance requirements, submitting and tracking referrals, and providing efficient patient flow and service excellence.
Requirements
- Demonstrated experience using multiple business software applications and insurance web portals simultaneously
- Prior experience in healthcare
Nice To Haves
- Associate or higher level degree
- One year of experience with referral services, referral processing, authorization/referral claims administration or a directly related field
Responsibilities
- Effectively identifies and resolves patient, provider, and staff requests which may include; referral processing, scheduling/registration, business/billing/payor inquiries, and medical requests.
- Uses analytical skills and technical resources to anticipate and resolve patient requests, demonstrates critical thinking and problem solving during challenging patient interactions and situations with ability to recognize and follow appropriate procedures for medical and non-medical emergencies.
- Contributes to and supports enterprise productivity and quality measures/initiatives by participating, planning, communicating, and encouraging team and individual contributions toward Intermountain Health Key Performance Indicators.
- Verifies eligibility and benefits; obtains authorizations, and tracks referrals to ensure compliance with guidelines.
- Acts as a liaison between hospitals, physicians, health plans, vendors and patients or other referral sources to submit for insurance authorization for procedures, specialist visits for patients referred by an Intermountain primary care provider.
- Gathers pertinent information from insurance carriers, financial counselors and other ancillary staff to make certain of the patients’ financial obligations for services provided.
- Documents appropriate and complete information within the referral shell to include authorization information, location patient referred to close the loop, coordinating with teams, providers, staff, insurance companies, patients, and other clinics.
- Follows the three-touch process, reach out to patient via MyChart, phone call and letter.
- Forwards all pertinent medical records and authorization information referred to the provider’s office.
Benefits
- Tuition coverage paid directly to the academic institution through the PEAK program
- 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
