Referral Specialist, Neurology

Beth Israel Lahey Health • Boston, MA

3d • $23 - $34 • Onsite

About The Position

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. The Referral Specialist position will support the Department of Neurology at large and will be responsible for the processing of managed care referrals as well as prior authorizations. This will begin as an on-site role, at Beth Israel Deaconess Medical Center in Boston, MA, Monday through Friday, first shift. Following three months of employment and upon being fully trained, the incumbent may work two days remotely per week. Job Description: Establishes and maintains effective procedures for managed care referrals for the department with commitment to providing the highest quality of service to patients in the ambulatory practice. Monitors outcomes to ensure insurance requirements are met. Provides referral management training and oversight to staff. Works closely with the Managed Care Office and BIDPO to communicate managed care principles and policies to the department.

Requirements

• High School diploma or GED required. Associate's degree preferred.
• 3-5 years related work experience required.
• Two years of experience in referral management or insurance managed care environment.
• Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.

Responsibilities

• Works with leadership to establish and maintain effective policies and procedures for managed care referrals, revenue cycle, and co-payment collection for the department.
• Ensures that all required managed care referrals for patient visits have been obtained or that a waiver is signed.
• Serves as primary resource on all departmental managed care matters; develops, implements and monitors departmental referral management processes, resource tools, and report findings on a regular basis.
• Represents the practice on hospital based Referral and Registration Operations committees.
• Acts as liaison between the practice and the managed care office and committees.
• Works closely with the physicians organization and the managed care office to communicate managed care principles and policies to the practice.
• Educates and trains administrative assistants and practice assistants in the area of Referral Management and Pre-Registration.
• Participates in administrative staff meetings reporting statistical referral management and pre-registration measurements and indicators, and communicating referral management information.
• Acts as a managed care resource on the unit to social workers, pharmacists, physicians, nurses and resource specialists for issues regarding managed care and insurance coverage, including commercial payers, Medicare, and radiology pre-certifications.

What This Job Offers

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