Referral Specialist
Referral Specialist
Posted on :
19-08-2025
Employer Active
1 Vacancy
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Job Description
Overview
The Referral Specialist works with patients requiring a referral to ensure patients referral needs are fulfilled for specialty service office visits. Processes referrals authorizations and pre-certifications for patients to ensure timely reimbursement.
Responsibilities
- Gather verify and process referrals authorizations and pre-certifications by working closely with physician(s) patients and payers.
- Communicate detailed information and answers patients questions regarding their health care plan; provide answers to billing and insurance clarification questions.
- Set up appointments coordinate clinic visits and any special arrangements such as transportation interpreter services specialty care etc.
- Coordinate flow of information between medical clinic and referral authorization department to secure a valid referral for clinic patient.
- Enter referrals documents communications and action into the system as appropriate.
- Notify physician(s) and patient when referral is denied or if additional information is needed.
- Develop and maintain database of referral physician offices preferred by each physician within the clinic.
- Assist Practice Manager with complaint resolution and solutions related to patient referrals.
- Perform other duties as assigned by the practice manager or physician.
Qualifications
Qualifications
- High school diploma or equivalent required.
- 2 years of progressively responsible related experience in a healthcare environment required.
Required Experience:
Unclear Seniority
Employment Type
Unclear
Key Skills
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