What are the responsibilities and job description for the Referral Specialist position at FirstHealth of the Carolinas, Inc.?
Overview
Must be capable of cross training and adapting to electronic medical records in a clinic setting showing progressive efficiently with this method of technology. Answers phones, routes calls and or takes accurate message. Adapts to a phone menu if one is in use. Demonstrates a sense of urgency relating to patient's level of distress. Schedules patient appointments with specialty providers including the correct processing of necessary referral forms and transfer of patient information. Reviews insurance to obtain authorizations for diagnostic testing, office visits, procedures, etc. Reviews clinical data to provide insurance company with information needed for authorization. Effectively communicates with the clinical team when an authorization is denied. Maintains referral record in Epic. Ensures referral data fields are completed. Opens and distributes incoming mail to appropriate parties. Meeting attendance as required.
High school graduate. 1-2 years of medical insurance experience or experience obtaining authorizations and referrals and medical office experience preferred.
Experience with EMR systems; office automation skills; extensive knowledge of CPT and ICD-10 coding and authorizations; strong interpersonal and verbal communication skills; good organizational skills. Is committed to and demonstrates excellent customer service when dealing with all types of customers.
