Referral Specialist, Interventional Pain Specialists

Valley Health•Winchester, VA

1d•Onsite

About The Position

The Insurance and Referral Specialist coordinates the front end of the revenue cycle by processing pre-registration, registration, demographic and financial verification activities. The specialist analyzes insurance payor/plans and verifies eligibility through Epic’s RTE platform or third-party websites, documents responses of eligibility accurately in the patient’s medical record. Coordinates with verification of insurance benefits for all patients within 48 hours of seminar attendance, calls patients within 72 hours of the seminar to communicate results of benefits verification and to schedule an initial consultation appointment. The specialist counsels patients with exclusions on self-pay and financing options and meet with each patient at the end of initial consultation appointment to discuss insurance and clinical requirements and the process to surgery. The Insurance and Referral Specialist is responsible for tracking patient status and entering all insurance and appropriate data in tracking tool. They collaborate with the bariatric patient navigators and other team members to ensure there is clear communication on insurance requirements, referring reason, patient preferences, etc. The Insurance and Referral specialist tracks referrals, responds to referring providers, contacts referred patients to initiate care and ensures referrals are completed properly.

Requirements

High School Diploma or GED is required. Five years medical clinic experience may be accepted in lieu of diploma.
Five years customer service-related experience is required.
Experience working in a medical clinic setting is required.
Experience with ICD and CPT coding is required.
Strong computer skills required.
Ability to demonstrate excellent judgment required.
Excellent verbal and written communication skills required.
Ability to accurately document patient status required.
Ability to manage multi tasks/assignments simultaneously required.
Ability to function as team member and promote teamwork required.

Nice To Haves

Three years working with insurance companies and obtaining authorizations is preferred.
Knowledge of EMR system preferred.

Responsibilities

Processes pre-registration, registration, demographic and financial verification activities.
Analyzes insurance payor/plans and verifies eligibility through Epic’s RTE platform or third-party websites.
Documents responses of eligibility accurately in the patient’s medical record.
Verifies insurance benefits for all patients within 48 hours of seminar attendance.
Calls patients within 72 hours of the seminar to communicate results of benefits verification and to schedule an initial consultation appointment.
Counsels patients with exclusions on self-pay and financing options.
Meets with each patient at the end of initial consultation appointment to discuss insurance and clinical requirements and the process to surgery.
Tracks patient status and enters all insurance and appropriate data in tracking tool.
Collaborates with bariatric patient navigators and other team members to ensure clear communication on insurance requirements, referring reason, patient preferences, etc.
Tracks referrals, responds to referring providers, contacts referred patients to initiate care and ensures referrals are completed properly.

Benefits

A Zero-Deductible Health Plan
Dental and vision insurance
Generous Paid Time Off
Tuition Assistance
Retirement Savings Match
A Robust Employee Assistance Program to help with many aspects of emotional wellbeing
Membership to Healthy U: An Incentive-Based Wellness Program
Health savings account
Flexible spending account for childcare
Life insurance
Short-term and long-term disability
Professional development
Discounts to on-campus dining