Insurance Specialist/Referral Coordinator

Insurance Specialist, Referral Coordinator for an ENT Medical Office.

We are a patient-centered clinic dedicated to providing exceptional care to our community. We are seeking a highly organized, detail-oriented, and compassionate candidate to join our team in Fort Worth, Texas. Candidates must possess a deep understanding of the Referring system, Insurance procedures, medical coding, and billing regulations to ensure that patients are receiving the best healthcare service.

Candidates must be organized and have excellent verbal and written communication skills.

This pivotal role will be responsible for helping the office manager by ensuring seamless patient access to specialized care through efficient referral management, while also overseeing the day-to-day operations of our busy medical office.

Job Responsibilities as Insurance and Reimbursement Specialist:

• Identify, investigate, and resolve incorrect insurance claim issues, claim denials, and discrepancies to maximize reimbursement.
• Maintain adequate knowledge of coding, compliance, and reimbursement procedures related to Medicare Risk Adjustment
• Insurance coverage Verification
• Correlating insurance coverage with services to be provided
• Communicating with Insurance companies, patients, and health providers.
• ABNs - Advance Beneficiary Notice of non-coverage services.
• Managing medical records
• Medical coding
• Review records, coding, and billing practices to ensure compliance
• Submit insurance claims to insurance carriers
• Follow up on unpaid claims
• Invoice preparation
• Identifying methods of payment for patients.
• Assist Surgery Schuler with Insurance Authorizations.
• Assist with Billing and Coding tasking.

Job Responsibilities as Referral Coordinator:

• Initiating referral processing by tracking and organizing referrals arriving from different platforms.
• Verifying insurance information, insurance benefits, and patient eligibility.
• Initiate PCP Insurance authorization and communicate with referral sources and patients.
• Assist with patient registration and patient appointment scheduling.
• Ensures that referrals are addressed promptly.
• Assist patients in scheduling appointments and managing insurance issues.
• Contact insurance companies to ensure verification of benefits and PCP prior authorization approval requirements are met.
• Correlating insurance coverage with services to be provided
• Communicating with Insurance companies, patients, and health providers.
• ABNs - Advance Beneficiary Notice of non-coverage services.
• Medical Records processing and requests.

Qualifications:

• Proven experience with two to three years in a medical office setting, with a strong focus on insurance & referrals, billing & coding.
• Excellent knowledge of insurance verification and authorization processes.
• Familiarity with medical terminology and coding.
• Strong organizational, time-management, and multitasking skills.
• Excellent communication and interpersonal skills.
• Proficiency in electronic health records (EHR) systems. NextGen is a plus.
• Ability to work independently and as part of a team.
• Strong problem-solving and decision-making skills.
• Experience with office management responsibilities.
• High School Diploma or equivalent required. Associates or bachelor's degree preferred.

Benefits:

• Competitive salary commensurate with experience.
• Comprehensive benefits package including medical, dental, vision, pet insurance, PTO, 401-K.
• Friendly and supportive work environment.
• Opportunity for professional growth.
• Stable and growing medical practice.

To Apply:

Please submit your resume and cover letter to hr@txhealthcare.com. In your cover letter, please highlight your experience with insurance referrals and office management in a medical setting.

Texas Ear Clinic is an Equal Opportunity Employer. We are committed to creating a diverse and inclusive workplace.

We look forward to welcoming you to our team!