Referral & Insurance Specialist - Physician Practice - Neurology

Bon Secours Mercy Health•Midlothian, VA

About The Position

The Referral and Insurance Specialist obtains insurance authorizations for referrals to physicians and medical facilities, procedures, testing, and medications. The role verifies eligibility and coverage, schedules appointments, communicates referral outcomes and instructions to patients, and investigates billing problems and denials. It also handles patient and insurance information in billing systems, prepares and maintains chart materials, posts payments, balances daily collections, and assists patients with billing questions and account resolution. The specialist supports clinic operations by answering calls, greeting and screening visitors, coordinating patient movement, organizing records, and collaborating with physician offices on coding, errors, and missing information. The position is in the Neurology physician practice and is scheduled for 40 hours per week on the day shift.

Requirements

High school diploma or GED.
2–3 years of experience in a related medical field with experience processing referrals (preferred).

Nice To Haves

2–3 years of experience in a related medical field with experience processing referrals.

Responsibilities

Obtain authorizations from insurance companies or pharmacy benefit managers for referrals, procedures, testing, and medications.
Verify insurance eligibility and coverage for referrals and testing by phone, fax, or Internet.
Schedule appointments with physicians and medical facilities for testing.
Notify patients in a timely manner whether referrals are authorized or denied and provide patient instructions.
Investigate billing problems and denials.
Enter and update patient and insurance information in billing systems to maintain accurate records.
Answer telephone calls, take messages, schedule appointments, and greet patients as needed.
Prepare daily patient charge encounter forms and create or update patient charts as needed.
Oversee the waiting area, coordinate patient movement, and report problems or irregularities.
Screen visitors and respond to routine requests for information.
Organize and file progress notes, testing reports, and other chart-completion forms; assist with filing patient charts.
Collect patient balances and copayments, balance money collected daily, and post payments to the appropriate patient accounts.
Open and distribute daily mail as needed.
Collect physician charge slips, reconcile their numbers and totals, and enter charge information into the online billing system.
Assist with coding and error resolution and request needed information by working with physician offices.
Assist patients with billing questions and account resolution.
Review information to determine an appropriate course of action for patients and refer them to the local DSS office when appropriate.