Health Plan Referral Specialist
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Job Location:
Irving, TX - USA
Monthly Salary:
Not Disclosed
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
Job Title: Health Plan Referral Specialist
Location: Irving TX (Onsite)
Job Type: Contract
Hours: Monday - Friday 9:00 AM to 5:00 PM
Pay Rate: $18.13/hr
NOTE: We will consider only U.S. citizens and Green Card holders.
Summary:
We are seeking a detail-oriented and organized Health Plan Referral Specialist to join our team. The ideal candidate will have experience in a hospital physician office or managed care setting and will be responsible for processing referral authorizations managing claims and ensuring accurate documentation in compliance with company policies.
Responsibilities:
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Expedite the flow of referral authorization requests through the managed care system.
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Prepare and process service authorization requests ensuring forms are complete and eligibility benefits and charts are verified.
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Accurately enter referral information into the computer system including type status and procedure codes.
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Document authorizations and maintain tracking for all services.
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Notify patients and providers of authorization decisions.
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Generate system reports to monitor referral activities and support management reporting.
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Research and resolve problem referral claims or requests for payment.
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Utilize tracking systems to monitor referrals and measure processing efficiency.
Requirements:
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High School Diploma or equivalent (proof of education required).
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Minimum of 2 years experience in a hospital physician office or managed care organization.
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Working knowledge of medical terminology and CPT codes.
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Strong typing and computer skills.
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Ability to accurately process and track referrals while maintaining compliance and attention to detail.
Skills:
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Healthcare knowledge
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Insurance claims processing
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Member services
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Data entry and documentation
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Communication and organizational skills
Required Skills:
Insurance Claims > Claims AdjustingHealthcareMEMBER SERVICES REPRESENTATIVEInsurance
Key Skills
- Accounts Handling
- Access
- Commissioning
- Biotechnology
- Civil Engineering
- Health And Safety Management
