Referral specialists are responsible for ensuring patients are already cleared for specialty service office visits. They resolve registration precertification and caserelated affairs before the clients appointment. Also they give support to clinical staff to manage the administrative components of clinical referrals for many services. They must gather relevant information from financial counselors insurance carriers and other supplementary staff to make sure the patients financial responsibility for services are provided. Additionally they act as a liaison between the patients physicians hospitals health insurance vendors or other referral sources.
Research referrals and either deny or approve based on information obtain and appropriately identify diagnosis (CPT and ICD9 coding).
Maintain confidentiality by following all applicable HIPAA regulations.
Maintain accurate EMR documentation of all service given to patient under strict confidentiality.
Coordinate patient data collection with various schedulesappointments for patients upon receipt/confirmation of authorization from referral source.
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