Referral/Precertification Specialist

The referral Specialist is responsible for obtaining insurance authorizations, answering phones, maintaining and updating health care records and performing data entry.  She will also assist with medication refills and prior authorization for medications, as well as processing medical records requests, and additional duties as assigned. This position requires a highly organized professional with excellent customer service skills, phone etiquette, knowledge of Microsoft Office applications, fax machines, internet software, and knowledge of the referral process with various insurance carriers.                                                                                                               

Advocare, LLC is a partnership of the top doctors in New Jersey and Pennsylvania, including pediatricians, family practice and specialist. As part of the team, you’ll work side-by-side with forward-thinking professionals who strive to provide the highest quality medical care by meeting and exceeding standards for clinical outcomes while delivering exceptional patient service in an evolving healthcare environment.

Essential Functions:

Answer phones, process referral requests and address patient questions

Process insurance authorizations and update patient records

Provide customer service to patients, other departments, and outside entities.

Verify eligibility of benefits.

Data entry of medical records and patient information

Good communication skills and the ability to work with others in a busy office environment. 

Required Skills/Abilities:

At least one year of experience in providing referral and utilizing the various insurance portals. 

Accurate typing and date entry skills

Superb customer service and communication skills

Knowledge of HIPPA requirements regarding patient confidentiality.

Ability to prioritize job duties to meet deadlines.

Knowledge of Microsoft applications MS Word, Excel, and Outlook

Have organizational skills to maintaining logs, medical record requests, and provide follow-up with other departments.

Ability to read and interpret documents such as patient charts, safety rules, operating and maintenance instructions, and procedure manuals.  Ability to write reports, correspondence, and patient notes when requested. Ability to speak effectively and clearly to patients and their family members.

Education and Experience:

A high school diploma or GED certificate (preferred)

At least one year of experience in a medical office or similar setting

Experience with EMR, Accounts Payable, Referral Portals, Interacting with Patients

Experience in a medical facility environment