Referral Specialist

Holland Hospital • Washington, DC

7d • Onsite

About The Position

Under minimal supervision and with accuracy, performs duties to support department services. Performs insurance verification, registration and scheduling for a series of patients for numerous providers. Supports the department(s) clinical staff members, maintains medical record files, and performs charge/billing duties. Answers phones and directs callers to the appropriate person/department. Greets clients, and sorts and sends mail.

Requirements

• One year of experience in an office setting with similar duties required.
• High school diploma or GED equivalent required.
• General working knowledge of and ability to use office machines (including computer, fax, copy machine, and printer).
• Excellent communication and interpersonal skills.
• Ability to work independently as well as part of a team.
• Microsoft Office skills.
• Knowledge of medical terminology.
• Ability to multitask.

Nice To Haves

• For Sleep Center Employees: BLS Certification Required

Responsibilities

• Receives referrals from various referring physicians’ offices.
• Manages referrals originating through various IT systems.
• Verifies all information needed and enters referrals into appropriate systems.
• Based on referral information and physician order, determines if the services require prior authorization.
• Tracks and records all referrals for management use in quality data to support accreditation requirements.
• Sends referrals back to referring offices once services are complete.
• Based on referral information, determines if the services require prior authorization.
• Collects additional information needed for pre-authorization via patients medical records and previous office visits.
• Contacts the insurance carriers to request authorization prior to services being rendered.
• Manages denials and appeals for all services and enters the appropriate authorization information into patient medical record / encounter.
• Works with Patient Financial Services to ensure completion of all prior-authorizations done for the department.
• Performs scheduling of patient appointments in all service scheduling apps.
• Manages schedules that are responsive to patient convenience while also optimizing efficiency in line with department goals.
• Verifies and updates all required patient demographic information.
• Pre-registers appropriate patients before arrival for their scheduled service.
• Continuously updates department tracking spreadsheets.
• Sends weekly team e-mails updating referring offices on scheduling dates for their patients.
• Anticipates and provides support to all clinical staff.
• Assures that messages and mail are distributed in a timely and accurate manner.
• Provides clerical support to department leadership creating documents such as spreadsheets and forms.
• Takes minutes at meetings when asked.
• Completes projects as assigned by leadership.
• Multi-tasks between scheduling, registration, reception and other office duties.
• Identifies and maintains office/medical supplies and forms that need to be ordered.
• Greets clients in a professional manner and advises the appropriate staff member that the patient is waiting.
• Answers the phone promptly and courteously.
• Accurately takes and routes messages; assists callers to obtain satisfactory responses to their requests.
• Notifies staff of cancellations and filling open time slots.
• Makes reminder phone calls to the next days scheduled patients and provides appropriate pre-test instructions.
• Screens calls as appropriate and communicates with patients and provider offices in a professional manner.
• Coordinates with various medical groups to provide coverage for tests that require provider supervision.
• Maintains patient rights, confidentiality and ethical billing practices.

Benefits

• Holland Hospital is an Equal Opportunity Employer, please see our EEO policy
• In a word—caring. Here, we not only strive to provide the best possible care to our patients, but also nurture the continued health and wellness of our most valuable asset: our employees.
• We believe superior service is only possible with a superior workforce.
• Our collaborative, can-do culture makes all things possible.
• And, our family-like feel makes Holland Hospital not only a great place to work, but a career that feels like home.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED