Referral Specialist - Georgetown Clinic (1.0 FTE)

Neighborcare Health•Seattle, WA

4d•$24 - $30

About The Position

The Referral Specialist receives, analyzes, and processes patient referrals and authorization requests according to insurance requirements. The role ensures patients are cleared for specialty office visits and certain procedures, and supports clinical staff with the administrative components of referrals. The Specialist works with the Coding Team to ensure referral billing codes are accurate and with the Insurance Verification Team to verify insurance before referrals or prior authorizations are submitted. Responsibilities also include coordinating patient care with specialists, verifying insurance and benefits, and obtaining prior authorizations.

Requirements

Working knowledge of electronic health record systems.
Knowledge of ICD-10 and CPT coding.
Ability to work effectively with a team and with patients.
Ability to use personal computers and learn company software, including practice management systems, spreadsheets, and word-processing applications.
Knowledge of billing rules for government and third-party payers.
Time-management skills and proficiency in data entry.
Ability to understand the clinical content of a health record.
Effective written and oral communication skills, including presenting, explaining, and writing information clearly, concisely, and in an organized format.
Ability to work effectively with healthcare professionals at all levels.
Associate’s degree (AA) or equivalent from a two-year college or technical school.
Two years of experience in a medical setting, or an equivalent combination of education and experience.

Responsibilities

Process physician referral orders, including EKG, EMG, CT, and MRI orders, through the EHR system and obtain required authorizations in a timely manner.
Enter accurate notes in the EHR about insurance-company letters, correspondence, authorization decisions, and other referral notifications.
Apply knowledge of medical terminology, ICD-10, and CPT coding.
Communicate authorization-request results to patients.
Answer incoming calls from patients and insurance companies.
Maintain current knowledge of insurance plans and billing rules.
Coordinate patient care with specialists and verify patient insurance and benefits.
Perform other duties as assigned within job qualifications.