Referral Specialist - Front Office Specialty Scheduling

IU Health•Muncie, IN

7d•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, aiming for 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 with the multidisciplinary team to achieve desired clinical, service, and cost outcomes. The goal is to ensure patients obtain necessary third-party payer authorization to expedite reimbursement, provide valuable information for clinical decision-making, promote quality patient care, prevent costly payment denials, and reduce the institution's 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

Cerner skills a plus

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