Referral Specialist

Mountain Management Services • Ringgold, GA

1d • $17 - $24

About The Position

As a Referral Specialist at CommonSpirit Medical Group - Family Medicine - Ringgold, you will manage patient referrals and authorization processes to help patients access specialized care. This includes obtaining clearances for specialty visits; issuing referrals for ancillary services such as consultations, imaging, and laboratory tests; and securing approvals for medications, durable medical equipment, home health, and other services.

The role works closely with physicians, patients, and payers to process orders and coordinate referral authorizations. It also involves answering patient questions about health care plans, billing, and insurance; arranging appointments and special services; providing patients with referral details and contact information; documenting testing and referral activity in PPMS and AEHR; and following up to confirm electronic or faxed referrals are received.

Requirements

• High school diploma in General Studies and 2 years of progressively responsible related experience in a healthcare environment, or GED in General Studies and 2 years of progressively responsible related experience in a healthcare environment.
• Meticulous attention to detail, strong organizational skills, and clear communication.

Nice To Haves

• 2 years of progressively responsible related experience in a healthcare office environment specializing in the referral process.
• Experience with AEHR and PPMS systems.

Responsibilities

• Gather, verify, and process orders for tests, referrals, authorizations, and pre-certifications in coordination with physicians, patients, and payers.
• Communicate information about health care plans and answer patients’ questions, including billing and insurance clarification questions.
• Set up appointments, coordinate clinic visits, and arrange special services such as transportation, interpreter services, and specialty care.
• Provide patients with written or verbal referral information, including the date, time, location, and relevant contact information.
• Coordinate information between the medical clinic and patients’ insurance companies to obtain valid referral authorizations.
• Enter and annotate testing information and referrals; complete electronic referrals for applicable practices; follow up to confirm electronic or faxed referrals are received; and document communications and actions in PPMS and AEHR, as appropriate.

What This Job Offers

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