Referrals Specialist

TEKsystems•Chula Vista, CA

20h•$25 - $25•Onsite

About The Position

Accurately receive and process authorization requests promptly, ensuring completeness and high-quality work. Coordinate and schedule referrals and treatment authorization requests efficiently. Secure authorizations from various insurance providers through phone, written communication, email, or fax, while adapting to evolving organizational processes. Proactively follow up on outstanding or missing documentation needed to complete authorizations. Arrange appointments for specialty services, diagnostic tests, Durable Medical Equipment (DME), and other support services as ordered by the primary care provider. Manage and coordinate patient care in accordance with guidelines from multiple insurance plans, contracts, and coverage types. Utilize different system applications to access information, schedule services, track referrals, and obtain authorizations. Provide timely and accurate updates on authorization status by evaluating requests and communicating relevant information to patients. Maintain a professional demeanor in both verbal and nonverbal communication, adapting style based on the audience. Listen attentively to patient concerns, whether over the phone or in person, and respond appropriately to meet their needs. Foster collaboration by considering and incorporating diverse perspectives. Consistently meet established deadlines and performance expectations. Manage referral closure processes by reviewing referral logs regularly to verify patient appointment completion. Update referral records with appointment details, including date and time. Confirm whether patients attended scheduled appointments and follow up with specialists or facilities to obtain visit notes or test results.

Requirements

A minimum of 1 year experience working in a healthcare setting to include both front and back office and/or referral authorization experience, as well as knowledge of different health plans, programs, and eligibility guidelines.
At least 2 years of customer service experience.
Bilingual English/Spanish is required.
TYPING TEST 35 WPM

Nice To Haves

referral intake
Authorizations
EMR
spanish bilingual
Appointment Coordination
EPIC
Customer service
Call Center

Responsibilities

Accurately receive and process authorization requests promptly, ensuring completeness and high-quality work.
Coordinate and schedule referrals and treatment authorization requests efficiently.
Secure authorizations from various insurance providers through phone, written communication, email, or fax, while adapting to evolving organizational processes.
Proactively follow up on outstanding or missing documentation needed to complete authorizations.
Arrange appointments for specialty services, diagnostic tests, Durable Medical Equipment (DME), and other support services as ordered by the primary care provider.
Manage and coordinate patient care in accordance with guidelines from multiple insurance plans, contracts, and coverage types.
Utilize different system applications to access information, schedule services, track referrals, and obtain authorizations.
Provide timely and accurate updates on authorization status by evaluating requests and communicating relevant information to patients.
Maintain a professional demeanor in both verbal and nonverbal communication, adapting style based on the audience.
Listen attentively to patient concerns, whether over the phone or in person, and respond appropriately to meet their needs.
Foster collaboration by considering and incorporating diverse perspectives.
Consistently meet established deadlines and performance expectations.
Manage referral closure processes by reviewing referral logs regularly to verify patient appointment completion.
Update referral records with appointment details, including date and time.
Confirm whether patients attended scheduled appointments and follow up with specialists or facilities to obtain visit notes or test results.