Referral & Insurance Specialist - Ghent Station Medical Office Building
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 by phone, fax, or internet; schedules appointments; and informs patients about the referral process and any instructions in a timely manner. The specialist supports medical office and billing operations by maintaining accurate patient and insurance information, preparing and organizing charts and encounter forms, entering charges, reconciling charge slips, and posting payments. The role also investigates billing problems and denials, assists with coding and error resolution, collects patient balances and copayments, and helps patients resolve account questions. Additional duties include answering phones, greeting and directing patients and visitors, overseeing the waiting area, handling mail, and referring patients to the local DSS office when appropriate.
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 insurance authorizations for referrals to physicians or medical facilities, procedures, testing, and medications.
- Verify eligibility and coverage for referrals and testing by phone, fax, or internet.
- Schedule appointments for testing at medical facilities and appointments with physicians.
- Notify patients in a timely manner whether referrals are authorized or denied, and provide instructions.
- Investigate billing problems and denials.
- Enter patient and insurance changes or corrections to maintain accurate billing-system information.
- 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 patient-chart filing.
- Collect patient responsibility balances and copayments as needed, and balance collections daily.
- Open and distribute daily mail as needed.
- Collect daily physician charge slips and reconcile their number and totals.
- Post payments to the appropriate patient accounts in computer billing systems.
- Enter charge information into the online billing system.
- Assist with coding and error resolution and request needed information from 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.
Benefits
- Competitive pay, incentives, referral bonuses, and 403(b) with employer contributions when eligible.
- Medical, dental, vision, and prescription coverage; HSA/FSA options; life insurance; mental health resources; and discounts.
- Paid time off, parental and FMLA leave, short- and long-term disability, and backup care for children and elders.
- Tuition assistance, professional development, and continuing education support.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
