Referral & Insurance Specialist - Depaul Medical Associates

Bon Secours Mercy Health•Norfolk, 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 insurance eligibility and coverage, schedules appointments, and notifies patients about referral decisions and instructions. It also handles billing and account support, including entering patient, insurance, and charge information into billing systems, posting payments, balancing daily collections, investigating billing problems and denials, and helping patients resolve account questions. The specialist supports clinic operations by answering phones, greeting patients, managing patient movement and waiting areas, maintaining and filing charts, and organizing records. Additional duties include reconciling physician charge slips, assisting with coding and error resolution, and making referrals to local DSS offices when appropriate. The position is with DePaul Medical Associates at Bon Secours.

Requirements

High school diploma or GED.
Experience in a related medical field, including processing referrals, is preferred; 2–3 years is stated as preferred experience.
No licensure or certification required.

Nice To Haves

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

Responsibilities

Obtain authorizations from insurers for referrals to physicians and medical facilities, procedures, testing, and medications.
Verify eligibility and coverage for referrals and testing by phone, fax, or Internet.
Schedule testing and physician appointments at medical facilities.
Investigate billing problems and denials, and notify patients promptly whether referrals are authorized or denied.
Provide patients with instructions and assist with billing questions and account resolution.
Enter and update patient and insurance information, charge information, and other pertinent data in billing systems.
Answer telephone calls, take messages, schedule appointments, and greet patients as needed.
Prepare daily patient charge encounter forms and create or update patient charts.
Oversee the waiting area, coordinate patient movement, report problems, screen visitors, and respond to routine information requests.
Organize and file progress notes, test reports, and other records; assist with patient chart filing.
Collect patient balances and copayments, balance money collected daily, and make daily deposits.
Open and distribute 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.
Assist with coding and error resolution and request needed information from physician offices.
Review information to determine an appropriate course of action for patients and refer them to the local DSS office when appropriate.