Referral Specialist
About The Position
The Referral Specialist is responsible for scheduling referrals for patients and providers, as well as pre-authorizing and pre-certifying tests/procedures. This role involves scheduling of other tests with facilities at the request of providers and/or staff. The Referral Specialist communicates effectively with patients, clinics, and hospitals. They review clinical data to report medical necessity to insurance companies and perform all work in accordance with the mission, vision, and values of the practice. Independence Physician Management (IPM), a subsidiary of UHS, develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve.
Requirements
- High school diploma or GED required
- Must maintain CPR certification
- Minimum of two years of clinical experience required.
- Knowledge of administrative and clerical procedures and systems, and other office procedures and terminology.
- Knowledge of electronic equipment, computer hardware and software, including applications and programming.
- Knowledge of principles and processes for providing customers and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
- EMR Experience
Responsibilities
- Scheduling referrals for patients, providers, pre-authorizing & pre-certing tests/procedures.
- Scheduling of other tests with facilities at the request of providers and/or staff.
- Directly communicates with the clinics, referred to clinics, and patients.
- Reviews clinical data to report medical necessity to insurance companies.
- Performs all work with accord to the mission, vision, and values of the practice.
Benefits
- Retention Bonus Program if offered.
- Loan Forgiveness Program if offered.
- Challenging and rewarding work environment
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(K) with company match and discounted stock plan
- SoFi Student Loan Refinancing Program
- Tuition savings to continue your nursing education with Chamberlain University
- Career development opportunities within UHS and its 300+ Subsidiaries!
- Pet Insurance
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
