Referral Specialist - Front Office Specialty Scheduling

Indiana University Health System • Muncie, DE

6d • Onsite

About The Position

This position is PRN, providing coverage for vacations or call-ins, with an expectation of 16-32 hours per month. The Referral Specialist collaborates with physicians, patients, and insurance companies to pre-certify medical services and procedures, ensuring quality medical care in the most cost-effective manner. This role serves as a key communication point among these parties and assists in utilization management by working collaboratively with the multidisciplinary team to achieve desired clinical, service, and cost outcomes. The specialist ensures patients obtain necessary third-party payer authorization for treatment to expedite full and timely reimbursement, providing valuable information for clinical decision-making and promoting quality patient care while preventing costly payment denials and reducing institutional financial risk.

Requirements

• High School diploma or equivalent
• 2-4 years of relevant experience
• Minimum one-year medical office experience or combination of extensive customer service work experience and education in insurance verification, patient registration, and medical terminology
• Working knowledge of payer billing requirements, regulations, and the third party appeal and denial process

Nice To Haves

• Previous Cerner experience

Responsibilities

• Patient experience with referral review and scheduling appropriately with correct providers and resources
• Professional Phone Skills
• Working as a team to cover all front office duties – faxing, managing messaging, registration check in, insurance reviews
• Positive demeanor
• Quick learner or previous Cerner experience

What This Job Offers

• Career Level: Mid Level
• Education Level: High school or GED