Job Description
Job Description
We are seeking a Referral Specialist responsible for managing patient referrals to OB/GYNE Providers by verifying insurance coverage, obtaining necessary authorizations, scheduling appointments, communicating with both patients and providers, and ensuring smooth transition of care between different healthcare levels. Essentially acting as a liaison between the referring physician and the specialist provider while prioritizing patient needs and adherence to insurance guidelines; this position will work in a medical office setting and require strong organizational, communication, and administrative skills to accurately process referrals and maintain detailed patient records.
Key responsibilities of a referral specialist may include:
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Receiving and processing patient referrals:
Reviewing patient medical records, identifying appropriate specialists based on diagnosis and insurance coverage, and initiating the referral process.
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Insurance verification and authorization:
Checking patient insurance eligibility, verifying benefits, and obtaining necessary prior authorizations for requested procedures or specialist visits.
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Patient communication:
Contacting patients to explain the referral process, schedule appointments with specialists, and address any questions or concerns.
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Provider communication:
Collaborating with referring physicians and specialists to ensure timely and accurate referral information is shared.
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Data entry and record keeping:
Maintaining detailed patient records, including referral details, insurance information, and appointment dates within electronic health records (EHR) systems.
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Follow-up on referrals:
Monitoring the status of referrals, and addressing any issues that may arise during the referral process.
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Compliance with regulations:
Staying updated on insurance guidelines, healthcare regulations, and referral protocols.
Required skills for a referral specialist:
- Excellent communication skills: Ability to interact effectively with patients, physicians, and insurance companies over the phone and in person
- Strong organizational skills: Efficiently managing a high volume of referrals and prioritizing tasks to meet deadlines
- Medical knowledge: Understanding basic medical terminology and healthcare procedures to accurately assess referral needs
- Insurance knowledge: Familiarity with different insurance plans and authorization processes
- Computer proficiency: Efficiently navigating EHR systems and data entry applications
- Attention to detail: Ensuring accuracy in patient information and referral documentation
This is a full time position with benefits.
Company DescriptionWomen's HealthFirst is a large OBGYN clinic with 5 locations in Schaumburg, Bartlett, Palatine Barrington, and Hoffman Estates.
Company Description
Women's HealthFirst is a large OBGYN clinic with 5 locations in Schaumburg, Bartlett, Palatine Barrington, and Hoffman Estates.