Referral Representative

Trinity Health

22h•Onsite

About The Position

This position is responsible for providing a variety of support services essential to the efficient operation of the organization’s referral process, working under the direction of the Referrals Supervisor. The role involves close collaboration with clinical department staff and customer service staff in the offices. The organization is a group of primary care providers, specialists, and surgeons serving patients in Connecticut and western Massachusetts, and is part of Trinity Health Of New England. Trinity Health is a large not-for-profit, faith-based health care system with 121,000 colleagues and nearly 36,500 physicians and clinicians across 27 states, including 101 hospitals and 126 continuing care locations.

Requirements

High Diploma or equivalent
Proficiency with all Microsoft products (Word, Excel, Power Point and Outlook) required
Excellent organizational skills and ability to multi-task
Excellent oral and written communication skills
Ability to evaluate and manage multiple priorities and demonstrate follow-through

Nice To Haves

Minimum of three (3) years’ experience in healthcare preferred
Experience within a medical office or billing department preferred
Medical terminology preferred
Knowledge of patient billing preferred
EPIC experience preferred

Responsibilities

Process and maintain the electronic Epic Referrals Workqueue prescreening for completeness of information, urgency, and other designated criteria
Completes pre-authorization workflows as required
Contact insurance companies to ensure prior approval requirements are met
Reviews and updates patient registration for membership eligibility and PCP selection
Enters referrals into the system per Trinity Health Of NE MGPS per protocols and provides feedback to ordering provider as needed
Informs maintenance analyst/ resource library of payor, benefit specific information and provider contact information updates accordingly
Answers incoming phone calls as required to assist all internal and external customers by offering guidance and support for referral related questions, process and problems
Other duties as assigned by Manager and Supervisor