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Insurance Referral Specialist

McLaren Flint
Flint, MI Full Time
POSTED ON 1/3/2025 CLOSED ON 1/11/2025

What are the responsibilities and job description for the Insurance Referral Specialist position at McLaren Flint?

Position Summary

Under general supervision, processes patient referrals from and to other healthcare practices per provider request. Ensures that patients receive information regarding their referral prior to their scheduled appointment with the external provider. Ensures that all new patient records are received prior to the initial scheduled visit to the clinic. Processes proper insurance authorizations prior to patient’s scheduled appointments and verifies that new patient insurance is current and participates with organization.

Essential Functions and Responsibilities :

1.Evaluates and schedules new patient referrals. Communicates with referring organization and patient with details of appointments.

2.Reviews content of new patient referrals and obtains appropriate records and scans / uploads to EMR prior to scheduling the appointment. Obtains disks with performed studies at outside facilities. Utilizes connection to PACS to have images transferred from available sites.

3.Access internal and external EMR systems to obtain records on patients of the department

4.Works with clinical staff when needed to evaluate the timing of scheduling the new patient appointment.

5.Documents in EMR the communication and status of new patient appointment.

Qualifications : Required :

  • Associate degree, or two years of college, and
  • 1 year work experience in an acute care setting or physician office with similar duties that includes extensive use of Electronic Medical Records
  • A High School Diploma and a minimum of 3 year of work experience in an acute care setting or physician office with similar duties that includes extensive use of Electronic Medical Records.
  • Medical Assistant certificate from a CAAHEP-accredited program can be used to substitute up to 12 months of the work experience requirement.

Preferred :

  • Experience with insurance coverage verification and obtaining insurance authorization for outpatient procedures.
  • Experience with coordination and scheduling in-patient and out-patient procedures
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