Referral Representative

Position Purpose:

Working under the direction of the Referrals Supervisor, this position is responsible providing a variety of support services which are essential to the efficient operation of the organization’s referral process. Works closely with the clinical department staff as well customer service staff in the offices.

What you will do:

• Process and maintain the electronic Epic Referrals Workqueue prescreening for completeness of information, urgency, and other designated criteria
• Completes pre-authorization workflows as required. Contact insurance companies to ensure prior approval requirements are met.
• Reviews and updates patient registration for membership eligibility and PCP selection.
• Enters referrals into the system per Trinity Health Of NE MGPS per protocols and provides feedback to ordering provider as needed.
• Informs maintenance analyst/ resource library of payor, benefit specific information and provider contact information updates accordingly
• Answers incoming phone calls as required to assist all internal and external customers by offering guidance and support for referral related questions, process and problems.
• Other duties as assigned by Manager and Supervisor

Minimum Qualifications:

• High Diploma or equivalent
• Minimum of three (3) years’ experience in healthcare preferred. Experience within a medical office or billing department preferred. Medical terminology preferred. Knowledge of patient billing preferred.
• Proficiency with all Microsoft products (Word, Excel, Power Point and Outlook) required. EPIC experience preferred.
• Excellent organizational skills and ability to multi-task. Excellent oral and written communication skills. Ability to evaluate and manage multiple priorities and demonstrate follow-through.

Position Highlights and Benefits:

• Day shift
• Great benefits effective day 1!
• Competitive pay!
• Growth Opportunities!
• Inclusive Culture!

We are a group of primary care providers, specialists and surgeons serving patients in Connecticut and western Massachusetts. Part of Trinity Health Of New England, we offer primary care, specialty care, surgery, urgent care, rehabilitation, and imaging and lab services for thousands of patients every year.

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.