<h3>Job Description</h3>
Job Description
Apicha Community Health Center aims to improve community health by providing access to comprehensive primary care, preventive health services, mental health, and supportive services. The center is dedicated to delivering high-quality, culturally competent services that enhance the quality of life. It also advocates for and offers a welcoming environment for underserved and vulnerable populations.
 
Position Summary:
We're looking for a resourceful and empathetic full-time Referral Specialist for our Jackson Heights location who will maintain, track, assemble and review patients’ documentation on referrals to ensure patient safety and provide appropriate clinical information to specialist per referral guidelines.
 
Job Responsibilities:
<ul>
<li>Maintain ongoing tracking and appropriate documentation on referrals to ensure patient safety.</li>
<li>Per referral guidelines, provide appropriate clinical information to specialist. Relates given information concerning</li>
<li>patient's clinical background and referral needs.</li>
<li>Contact review organizations and insurance companies to ensure prior approval requirements are met. Present</li>
<li>necessary medical information such as history, diagnosis and prognosis as documented on the referral.</li>
<li>Review details and expectations about the referral with patients.</li>
<li>Identify and utilize cultural and community resources. Establish and maintain relationships with identified service</li>
<li>providers.</li>
<li>Ensure that referrals are addressed in a timely manner.</li>
<li>Follow-up with referrals to ascertain attendance and obtain a completed report.</li>
<li>Remind patients of scheduled appointments via mail or phone.</li>
<li>Performs other duties as may be assigned</li>
</ul>

Qualifications: 
<ul>
<li>High school diploma required; medical assistant certification preferred</li>
<li>Strong customer service focus</li>
<li>Effective verbal and written communication skills</li>
<li>Organized and able to manage competing priorities</li>
<li>Good judgment</li>
<li>Resourcefulness in problem solving</li>
<li>Able to take and follow through with delegated tasks</li>
<li>Ability to work with all clients regarding their individual health maintenance needs.</li>
<li>Ability to work both independently and in a team to meet the objectives of all programs.</li>
<li>Ability to work with people from diverse backgrounds in multi-cultural setting required.</li>
<li>Knowledge eClinicalWorks EMR preferred</li>
</ul>
At Apicha, we believe that serving the needs of our staff is just as important as serving the needs of underserved people of New York City as such we are proud to offer our team members a competitive employee benefits package which include 12 Paid Holidays, vacation and sick leave, Health Insurance Coverage, Flexible Spending Account, Life Insurance, Employee Assistant Program just to name a few.

REFERRAL SPECIALIST

<h3>Job Description</h3>
Job Description
The Referral Specialist is an integral part of the clinic team. Responsibilities include coordinating referral processes for the assigned area of service(s) or provider(s) by preparing referrals and obtaining authorizations and pre-certifications. The Referral Specialist also verifies patient’s benefits and eligibility and may assist patient in obtaining proper paperwork for claims. 
Duties and Responsibilities
The Referral Specialist performs the following duties as assigned.
<ol>
<li>Provides clerical services.
<ol>
<li>Coordinates and facilitates referrals according to the process as defined in Referral Specialist training.</li>
<li>Ensures patients have been cleared for specialty services, as required by provider/insurance.</li>
<li>Resolves pre-certification, registration and case-related concerns prior to a patient’s appointment. </li>
<li>Gathers pertinent information from insurance carriers, financial counselors, and other staff to make certain the patient's financial obligations for services provided. </li>
<li>Follows up with patient to confirm appointment; reschedules if necessary</li>
<li>Provides support to clinical staff in order to facilitate the administrative components of clinical referrals for various services. </li>
<li>Acts as a liaison between hospitals, physicians, health plans, vendors, and patients, or other referral sources. </li>
<li>Verifies insurance coverage and obtains authorizations if needed from insurance coverage. </li>
<li>Accurately enters referrals and documents communications, actions, and other data in an information system. </li>
<li>Reports issues, non-compliance or patient no shows to Practice Manager, Supervisor (Coordinator) or Provider</li>
<li>Answers telephone lines promptly, greets appropriately.</li>
<li>Handles inquiries when able and/or refers them to appropriate personnel.</li>
<li>Secures all necessary signatures to facilitate referral.</li>
<li>Various secretarial duties. </li>
<li>Verifies insurance benefits and obtains necessary information needed. </li>
</ol>
</li>
</ol>
<ol>
<li>Demonstrates strong initiative to get daily work finished and processed.</li>
<li>Communicates effectively with patients, physicians, providers and others. </li>
<li>Demonstrates accurate judgment.</li>
<li>Notify supervisor of any problems, in a timely manner and works to resolve said issues.</li>
</ol>
<ol>
<li>Fulfills administrative duties.
<ol>
<li>Assists in maintaining an efficient, safe, secure, orderly, and aseptic environment of care for all patients and employees.</li>
<li>Is familiar with and abides by OSHA Standards, Hazardous Materials, Universal Precautions, use of personal protective equipment, Evacuation, Fire, Disaster, and Safety Plans.</li>
<li>If bilingual, translates in Spanish between non-Spanish speaking staff and Spanish speaking patients as requested.</li>
</ol>
</li>
<li>Performs all other duties as assigned.</li>
</ol>
Knowledge, Skills and Abilities
Required
<ul>
<li>Knowledge of protocols in general and an ability to quickly gain specific knowledge of the Clinic’s current operational protocols</li>
<li>Knowledge of medical terminology and appropriate abbreviations</li>
<li>Ability to read and comprehend short correspondence, and memos</li>
<li>Ability to document, with clarity, all information relevant to a patient’s needs</li>
<li>Ability to effectively present information in small group situations to patients, Clinic staff, and the general public. </li>
<li>Ability to work cooperatively with community agency personnel to coordinate services for patients</li>
<li>Ability to use office equipment including but not limited to computers, fax machines, telephones and copiers</li>
<li>Ability to prioritize and allocate resources</li>
</ul>
Preferred
<ul>
<li>Spanish speaking and writing skills</li>
</ul>
Education and Experience
Required
<ul>
<li>High School Diploma</li>
</ul>
Preferred
<ul>
<li>One (1) year of practice experience in a clinic office setting.</li>
</ul>
<ul>
<li>Licensed Vocational Nurse (LVN) or Certified Medical Assistant</li>
</ul>
Special Requirements
The employee must be able to lift and/or move more than 50 pounds. Requires full range of body motion including handling and lifting patients, manual and finger dexterity and eye/hand coordination. Requires sitting, standing and walking for extensive periods of time. Requires working under stressful conditions or working irregular hours. Requires frequent exposure to communicable diseases, body fluids, toxic substances, medicinal preparations and other conditions common to a clinic environment. The employee frequently is required to reach with hands and arms. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Ability to work with a moderate noise level in the work environment is required. Ability to handle significant stress.
 Monday - Friday 8am - 5pm

Referral Specialist

<h3>Job Description</h3>
Job Description
As a Referral Specialist at St. John’s Community Health, you will be responsible for managing the pre-authorization process for external referrals, including radiology referrals initiated by patients’ primary care providers. Your role is essential in ensuring timely and accurate coordination between patients, healthcare providers, and insurance companies. This position requires strong attention to detail, excellent communication skills, and a thorough understanding of medical terminology, insurance requirements, and healthcare regulations to facilitate seamless access to specialized care.
What makes a good Referral Specialist?
 
A Referral Specialist is detail-oriented, organized, and highly knowledgeable about medical terminology, insurance protocols, and healthcare workflows. They serve as a critical link between patients, providers, and payers, ensuring timely access to necessary medical services.
 
Benefits
<ul>
<li>Free Medical, Dental &amp; Vision </li>
<li>13 Paid Holidays + PTO </li>
<li>403 (B) retirement match </li>
<li>Life Insurance, EAP </li>
<li>Tuition Reimbursement</li>
<li>SEIU Union </li>
<li>Flexible Spending Account </li>
<li>Continued workforce development &amp; training </li>
<li>Succession plans &amp; growth within</li>
</ul>
 
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Education &amp; Experience
Education: (Required)
<ul>
<li>High School Diploma or equivalent </li>
<li>An associate's or bachelor’s degree in healthcare administration, business administration, or a related field is preferred.</li>
<li>Certification as a Medical Assistant, Medical Office Specialist, or Certified Professional Coder (CPC) is a plus.</li>
</ul>
Experience: (Required)
<ul>
<li>Minimum of 3+ years of experience in healthcare administration, medical billing, or referral coordination, preferably in a high-volume clinical setting.</li>
<li>Bilingual in English and Spanish preferred.</li>
<li>Advanced proficiency in Microsoft Office, including Excel, Word, and Outlook, with experience generating reports and analyzing data.</li>
<li>Strong knowledge of medical terminology, diagnosis codes (ICD-10), and procedure codes (CPT).</li>
<li>Extensive experience with electronic health records (EHR) and practice management software; eClinicalWorks experience is a plus.</li>
<li>In-depth understanding of healthcare compliance, including HIPAA, Medicare, and Medicaid guidelines.</li>
<li>Strong background in insurance verification, prior authorizations, and appeals processes.</li>
<li>Proven track record of providing high-level customer service and patient advocacy.</li>
<li>Excellent interpersonal, verbal, and written communication skills, with the ability to liaise effectively between patients, providers, and insurance companies.</li>
<li>Strong teamwork orientation with the ability to lead and train staff as needed.</li>
<li>Ability to prioritize, multitask, and work independently in a fast-paced, deadline-driven environment.</li>
<li>Strong analytical and problem-solving skills, with demonstrated resourcefulness and sound judgment in resolving complex referral and authorization issues.</li>
</ul>
Essential Duties And Responsibilities
Performs a combination, but not necessarily all, of the following duties:
<ul>
<li>Receive, review, and process referral requests from healthcare providers, patients, and insurance companies with accuracy and efficiency.</li>
<li>Verify patient insurance coverage, eligibility, and authorization requirements for requested services, ensuring compliance with payer guidelines.</li>
<li>Assess referral requests for completeness, accuracy, and adherence to insurance and healthcare regulations.</li>
<li>Work directly with physicians, specialists, and healthcare providers to gather necessary medical documentation for approval.</li>
<li>Submit and track referrals through various web portals, including Medpoint Management, Optum, eConsult, Molina Direct, IEHP, and others.</li>
<li>Educate providers on referral timeframes and processes to ensure compliance and timely patient care.</li>
<li>Assign unassigned referrals to appropriate Referral Coordinators and evaluate workload distribution to maximize efficiency.</li>
<li>Ensure compliance with all federal, state, and regulatory agency requirements related to referral management and clinical decision support.</li>
<li>Meet or exceed productivity standards by processing an average of 60+ external specialty referrals or 85+ diagnostic imaging referrals daily.</li>
<li>Modify CPT/ICD-10 codes and extend authorizations as necessary to expedite approvals.</li>
<li>Process urgent referrals within 24 hours and routine referrals within 24-72 hours from the date ordered.</li>
<li>Assist with resolving complex referral issues, including troubleshooting authorization delays or denials.</li>
<li>Provide clear and professional communication with patients regarding referral status, required paperwork, authorizations, and appointment scheduling.</li>
<li>Educate patients on the referral process, addressing any questions or concerns with empathy and professionalism.</li>
<li>Ensure patients receive timely updates regarding approvals, denials, and next steps in their care.</li>
<li>Assist patients in navigating insurance requirements, ensuring they understand their benefits and responsibilities.</li>
<li>Act as the primary liaison between the clinic, insurance companies, and third-party payers to facilitate pre-authorization approvals.</li>
<li>Stay updated on insurance policy changes, reimbursement guidelines, and regulatory updates affecting referrals.</li>
<li>Troubleshoot and resolve insurance-related delays, working proactively to prevent denials.</li>
<li>Escalate complex insurance issues to management or designated personnel as needed.</li>
<li>Documentation and Recordkeeping.</li>
<li>Maintain comprehensive and up-to-date records of all referral requests, approvals, denials, and follow-up actions in the electronic medical records (EMR) system.</li>
<li>Ensure full compliance with HIPAA regulations and privacy laws when handling patient information.</li>
<li>Generate referral tracking reports and assist in analyzing referral trends to optimize workflow and efficiency.</li>
<li>Work closely with healthcare providers, medical staff, and administrative personnel to streamline the referral process.</li>
<li>Actively participate in interdisciplinary meetings, case conferences, and training sessions to improve communication and teamwork.</li>
<li>Serve as the primary clinic liaison to external agencies, healthcare networks, and specialty providers.</li>
<li>Notify the Manager when all tasks are completed early and assist team members as needed to prevent referral backlogs.</li>
<li>Train new staff members and educate providers on referral procedures, insurance protocols, and compliance requirements.</li>
<li>Handle patient complaints related to referrals and escalated issues as necessary for resolution.</li>
<li>Provide backup support to the Records team and Referral Call Center as needed.</li>
<li>Work one Saturday per month or as required to ensure uninterrupted referral processing and patient support.</li>
<li>Responsibilities are subject to change at the discretion of management to meet the evolving needs of the organization</li>
</ul>
St. John's Community Health is an equal opportunity employer.

Referral Specialist I

<h3>Job Description</h3>
Job DescriptionSalary: 
WHO WE ARE:
Columbia Pain Management is the Pacific Northwest's leading comprehensive spine, musculoskeletal, and interventional pain practice. We offer a multidisciplinary approach to caring for patients that incorporates the latest innovative interventional pain treatments.
 
Our goal is the accurate diagnosis and treatment of pain conditions using spinal injections, neuromodulation, vertebral augmentation, regenerative medicine, radiofrequency ablation, and percutaneous spine procedures. We strive to help patients minimize the use of opioid pain medications,encourage healthy habits, become more mobile and connected to their communities.
 
POSITION SUMMARY:
The Referral Specialist is responsible for a wide range of administrative duties to include incoming referral processing, verification of benefits, inputting data into electronic medical record, communication with patients, referral sources, and insurance companies, and other tasks assigned.
 
 
ESSENTIAL FUNCTIONS:
<ul>
<li>Coordinate, track, and communicate information related to related to patient referrals</li>
<li>Prioritize and process incoming referrals according to established procedure</li>
<li>Enter complete and accurate demographic and current insurance information in electronic medical record</li>
<li>Assemble information concerning patient clinical background and referral requests/expectations</li>
<li>Contact insurance companies to ensure verification of benefits and prior authorization approval</li>
<li>Handle information and status requests from patients and referral sources</li>
<li>Forward referrals to the correct team member for completion of further processing</li>
<li>Maintain a clean and organized work area.</li>
<li>Maintain confidentiality of all information related to patients and medical staff.</li>
<li>Demonstrate positive interactions with patients, vendors, fellow employees, and supervisors.</li>
<li>Perform other duties as required; daily tasks may vary based upon department needs.</li>
</ul>
 
QUALIFICATIONS/ATTRIBUTES:
<ul>
<li>Exceptional customer service skills</li>
<li>Proficiency in Microsoft Office: 1-2 years</li>
<li>Medical office experience: 1-2 years</li>
<li>Electronic Health Records: 1-2 years</li>
<li>Strong customer service focus</li>
<li>Effective verbal and written communication skills</li>
<li>Teamwork orientation</li>
<li>Organized and able to manage multiple priorities</li>
<li>Good judgement</li>
<li>Resourcefulness in problem solving</li>
<li>Able to take and follow through with delegated tasks and accountability</li>
<li>Strong attention to detail</li>
<li>Ability to stay focused in a busy environment and handle distractions well</li>
<li>Embrace new challenges with cheerful outlook</li>
<li>Reliable (you enjoy coming to work every day!)</li>
<li>Share our vision of putting patients first in everything you do</li>
</ul>
 
WE OFFER:
We believe that every individual brings a valuable set of skills to our organization, and we are pleased to offer the following benefits:
<ul>
<li>Generous vacation (starting at 2 weeks)</li>
<li>Paid health insurance</li>
<li>Paid dental and vision insurance</li>
<li>Retirement Savings Plan</li>
<li>Salary commensurate with experience</li>
</ul>
Columbia Pain Management is an Equal Opportunity Employer and we do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state, or local protected class.

<h3>Job Description</h3>
Job Description

Job Title: Referral Specialist I
FLSA Status: Non -Exempt
 
About us
Physicians East, P.A.is a team of skilled healthcare professionals united to meet the challenge of delivering quality, cost-efficient, comprehensive healthcare to the people of Eastern North Carolina.
Location &amp; commitments
FT/PT/Temp/PRN role based at our Greenville (other) location, Monday-Friday, 8a.m. – 5 p.m. Additional hours may be required to meet the needs of the business. Weekend work is rare but can occasionally be necessary.
 
Supervision Received: Reports to the QMS Operations Supervisor and Operations Manager.
Supervision Exercised: None.
 
Typical Physical Demands:
Requires prolonged standing or sitting. Requires frequent bending, stooping, or stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, and other office equipment.
 
Typical Working Conditions:
Normal office environment.
About the role
Coordinate incoming and outgoing referrals, answer department phone calls, and schedule patient follow-up appointments.
Responsibilities:
<ul>
<li>Schedule and coordinate outgoing referrals to offices both inside and outside of Physicians East.</li>
<li>Complete and send Request for Referral Appointment Authorizations to Managed Care Representative.</li>
<li>Notify patient of referred appointment date and time.</li>
<li>Coordinate and schedule patient follow-up appointments.</li>
<li>Follow through to verify appointment was kept and report to referring provider.</li>
<li>Answer multi-line phones, transfer calls, and successfully operate a fax machine. </li>
<li>Work as a contributing member of a team to keep departments running smoothly.</li>
<li>Participate in in-service education, staff meetings and other continuing education programs to maintain optimal technical knowledge.</li>
<li>Adhere to department and company policies.</li>
<li>Attend safety classes and compliance training as offered by Physicians East, P.A.</li>
<li>Always maintain confidentiality.</li>
</ul>
<ul>
<li>Participates in educational activities, as necessary.</li>
</ul>
<ul>
<li>Attends required meetings and participates in committees as requested.</li>
<li>Enhances professional growth and development through in-service meetings, education programs, conferences, etc.</li>
<li>Performs related work as required.</li>
</ul>
Candidate requirements:
<ul>
<li>Must have high school diploma or equivalent.</li>
<li>Associates Degree preferred in related field and at least 2 years of experience in medical office position or specialization required; or the equivalent combination of education and experience.</li>
</ul>
Key Skills and Personal Characteristics:
<ul>
<li>Must display a high level of confidentiality, integrity, and initiative.</li>
<li>Must be able to work well under stress, tight deadlines, and fast-paced environment. </li>
<li>Must have a strong sense of team commitment, which includes meeting deadlines, punctuality and excellent follow-through and feedback.</li>
<li>Ability to form positive and collaborative relationships with peers and physicians at all levels within the company.</li>
<li>Must possess exceptional interpersonal communication skills and can create a favorable impression for the organization to all staff, patients, and the public.</li>
<li>Must possess strong organizational and excellent communication skills as well as being highly motivated and detail oriented.</li>
</ul>
COMPUTER SOFTWARE UTILIZED: NextGen and Centricity EMR.
Affirmative Action/EEO statement
Physicians East, P.A.is an equal opportunity employer and will not discriminate against any applicant or employee on the basis of age, race, color, ethnicity, religion, creed, sex (including gender, pregnancy, sexual orientation, and gender identity, which includes status as a transgender individual), national origin or ancestry, citizenship, past, current, or prospective service in the uniformed services, genetic information (including family medical history), physical or mental disability, or other legally protected status. Reasonable accommodation will be made for persons with disabilities during the application process and/or at the time of employment. Requests for accommodation should be made to the Human Resources Department as early as possible in the application/employment process. Contact HR Office at 252-413-6368 or email <a href="mailto:careers@physicianseast.com" target="_blank">careers@physicianseast.com</a>
Disclaimer
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

<h3>Job Description</h3>
Job DescriptionDescription:
Summary:
The Referral Specialist answers the referral telephone line, manages and processes orders in the referral inbox, schedules appointments with outside providers, and communicates with patients regarding scheduling referral appointments. These scheduled tasks are performed in a professional and courteous manner.
 
Supervisory Responsibilities:
<ul>
<li>None</li>
</ul>
 
Major Duties &amp; Responsibilities: Job Skills:
<ul>
<li>Able to process orders and referrals for patients for services rendered outside of CHC in a timely manner.</li>
<li>Requires the ability to organize and set priorities to accomplish goals.</li>
<li>Requires interpersonal skills necessary to effectively interact and promote exceptional service to our patients, families, physicians, fellow employees, and volunteers by displaying attitudes and behaviors that reflect compassion, respect, and dignity to everyone we serve.</li>
<li>Answers and triages telephone calls and callbacks.</li>
<li>Exceptional phone courtesy skills, triaging phone calls, and callbacks</li>
<li>Proficient in using basic office equipment (i.e., fax, scanners, and computer)</li>
<li>Maintains a positive image and relationships with the referral healthcare community and agencies.</li>
<li>Schedules the referral appointments and sends appropriate documentation.</li>
<li>Manages the prior authorization process needed for referrals as dictated by payers.</li>
<li>Must use Christ Health policies and procedures as a guide for processing orders and tracking.</li>
</ul>
Requirements:
Qualification, Education, Experience:
<ul>
<li>High school diploma or equivalent.</li>
<li>EMR experience preferred.</li>
<li>Assists with recognizing the needs and concerns of people within their cultural framework,</li>
<li>and maintains constructive relationships in dealing with them .</li>
<li>Maintains open communication with Office Manager, Medical Assistants, Registered Nurses,</li>
<li>Mid-level providers, Physicians, and other staff.</li>
<li>Self-motivated and flexible to daily patient schedule and/or clinic needs.</li>
<li>Understands HIPAA requirements and obligations.</li>
<li>Ability to use Microsoft Office for letter writing, as well as other normal office equipment.</li>
<li>Ability to multi-task professionally in a fast-paced setting with maximum distractions.</li>
<li>Attends and participates in in-service education for staff, quality assurance program, and risk-management programs.</li>
<li>Each employee of Christ Health Center is vital to providing overall quality care to our patients and may be included in the patient care team and daily huddle when deemed necessary by the Core Care Team.</li>
<li>Performs other duties as assigned.</li>
</ul>
 
Attendance Standards:
<ul>
<li>Punctual and dependent for assigned/confirmed shifts.</li>
</ul>
 
Language Skills:
<ul>
<li>Able to read and comprehend simple instructions, short correspondence, and memos.</li>
<li>Able to write simple correspondence and reports.</li>
<li>Ability to effectively present information in one-on-one and small group situations to patients, visitors, and other employees of the organization.</li>
</ul>
 
Mathematical Skills:
<ul>
<li>Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.</li>
<li>Ability to compute rates ratios, and percentages.</li>
</ul>
 
Reasoning Ability:
<ul>
<li>The ability to apply general rules to specific problems to produce answers that make sense.</li>
<li>The ability to combine pieces of information to form general rules or conclusions (includes finding a relationship among seemingly unrelated events) and to convey the information to others.</li>
</ul>
 
Physical/Mental Demands:
<ul>
<li>Work requires the ability to lift objects weighing up to 20 pounds.</li>
<li>Work requires the ability to carry objects weighing up to 20 pounds.</li>
<li>Work requires ability to stand or sit +/- 90% of the time.</li>
<li>Work requires the ability to stoop and bend, to reach, and grab with arms and hands, manual dexterity, and to communicate with others.</li>
<li>Work requires proofreading and checking documents for accuracy.</li>
<li>Work requires the ability to use a keyboard and visualize a computer monitor to enter and transform words or data.</li>
<li>Work requires ability to multi-task as well as handle conflict resolution.</li>
</ul>
 
Environmental/Working Conditions:
<ul>
<li>Normal office environment</li>
<li>Full-time position</li>
</ul>
 
Cultural Expectations:
<ul>
<li>Understands Christ Health Center Mission Statement and Values.</li>
<li>Requires the ability to work in a multi-cultural setting.</li>
<li>Consistently displays Christ Health Center’s Mission daily.</li>
</ul>

<h3>Job Description</h3>
Job Description
THIS IS AN ENTRY LEVEL POSITION BUT LOOKING FOR A CANDIDATE THAT WANTS TO START A CAREER IN THE INSURANCE INDUSTRY AND WILL TAKE THE STEPS NEEDED TO GET INSURANCE LICENSED IN PROPERTY &amp; CASUALTY AND LIFE &amp; HEALTH.
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
This full-time entry level position offers the potential for advancement within the company based on both need and experience. As our company continues to grow, there will be opportunities to take on additional responsibilities. We value internal talent and prioritize promoting from within whenever possible. Your dedication and performance will be recognized, allowing you to progress and develop your career within our expanding insurance office. Working for our growing insurance office is an exciting opportunity that offers both challenges and rewards. Our team culture is supportive and collaborative, making it a fun place to work. We value innovation and creativity, encouraging you to bring fresh ideas to the table.
Starting pay will be determined by experience level and could be more than what is quoted on this site.
Responsibilities
<ul>
<li>Establish customer relationships and follow up with customers, as needed.</li>
<li>Develop leads, schedule appointments, identify customer needs, and market appropriate products and services.</li>
<li>Maintain a strong work ethic with a total commitment to success each and every day.</li>
<li>Attention to detail, the ability to handle rejection, offer rebuttals, and a friendly and professional demeanor are essential for success in this call center role.</li>
</ul>
As an Agent Team Member, you will receive...
<ul>
<li>Hourly pay</li>
<li>Valuable experience</li>
<li>Growth potential/Opportunity for advancement within my agency</li>
</ul>
Requirements
<ul>
<li>Available to work M-F 8:30am - 5:30pm in office.</li>
<li>Must maintain individual daily/weekly quotas.</li>
<li>Interest in marketing products and services based on customer needs</li>
<li>Excellent interpersonal skills</li>
<li>Excellent communication skills - written, verbal and listening</li>
<li>Excellent phone communication skills, objection handling, appointment setting</li>
<li>People-oriented</li>
<li>Self-motivated</li>
<li>Detail oriented</li>
<li>Dedicated to customer service</li>
<li>Ability to work in a team environment to meet quotas</li>
<li>Ability to effectively relate to a customer</li>
<li>Bilingual - Spanish preferred</li>
<li>Property and Casualty license (must be able to obtain)</li>
<li>Life and Health license (must be able to obtain)</li>
<li>Reliable transportation</li>
</ul>
If you are motivated to succeed and can see yourself in this role, please complete our application. We will follow up with you on the next steps in the interview process.
This position is with a State Farm independent contractor agent, not with State Farm Insurance Companies. Employees of State Farm agents must be able to successfully complete any applicable licensing requirements and training programs. By accepting this position, you are not guaranteed an agency position with State Farm Insurance Companies. As an agent team member, you will still need to go through the regular State Farm agent selection process when you are ready to pursue an agency opportunity. State Farm agents are independent contractors who hire their own employees. State Farm agents’ employees are not employees of State Farm.
Company DescriptionWe are an established, growth-oriented agency in Schertz, TX. Our team works hard to reach our goals together in a team environment. Attention to excellent customer service and detail is important. If you want to work in an environment that is challenging yet fun and rewarding, then Bill Hicks - State Farm Agency may be the right fit for you. 
<h3>Company Description</h3>
We are an established, growth-oriented agency in Schertz, TX. Our team works hard to reach our goals together in a team environment. Attention to excellent customer service and detail is important. If you want to work in an environment that is challenging yet fun and rewarding, then Bill Hicks - State Farm Agency may be the right fit for you.

<h3>Job Description</h3>
Job Description&nbsp;
Join an Organization that Puts its People First! *Please note, this is a remote position and the schedule for this position is Tuesday - Friday (8am - 2pm or 8:30am - 2:30pm PT) Interested in helping grow a healthcare model based on trusting relationships, joy in work, and health equity? Orchid Health might be just the place for you!
Orchid Health was founded 10 years ago with the belief that the most effective way to improve the health of our communities is through integrated patient-centered care that takes the time to listen to and build trusting relationships with each patient. We are committed to our communities and each other and are proud of the positive feedback and reputation that we have built. We currently see thousands of patients at our Oregon clinic locations, all supported by a talented, passionate, and dedicated staff.
Our mission is to advance a new model for community health to thrive based on relationships, joy in work, and health equity. We achieve this by leaning into our four pillars and core values:
&nbsp;
Core Values:
<ul>
<li>Challenge the Status Quo</li>
<li>Cultivate Respect</li>
<li>Courageously Vulnerable and Accountable</li>
</ul>
Four Pillars (in order of priority):
<ul>
<li>Pillar 1: Employee Well-Being</li>
<li>Pillar 2: Trusting Patient Relationships</li>
<li>Pillar 3: Community Health</li>
<li>Pillar 4: Financial Sustainability</li>
</ul>
&nbsp;
Why work for Orchid Health?
Orchid Health’s culture revolves around a healthy work-life balance, asking open-ended questions and providing transparent feedback, and learning from our mistakes. Orchid’s team members have abundant opportunities to expand their professional skills in a supportive environment, participate in community outreach efforts and partnerships, and enjoy a robust benefits package.&nbsp;
Compensation:
<ul>
<li>$20.50 – $22.25/hour depending on experience and skills&nbsp;</li>
</ul>
Benefits:
<ul>
<li>Medical, Dental, &amp; Vision – Orchid pays monthly premiums at 100% for team members and at 50% for their dependents for base medical and dental plans&nbsp;</li>
<li>$1000/year Wellness Benefit - for things that make you happy! (will be pro-rated for 0.6 FTE and based on date of hire)</li>
<li>401(k) with a company match</li>
<li>A Continuing Education / Continuing Medical Education budget for all team members</li>
<li>An Employee Assistance Program (EAP) that provides mental health support, financial planning, and lifestyle training opportunities, at no cost to employees</li>
<li>128 hours of PTO per year annually front-loaded with tenure-based increases (will be pro-rated for 0.6 FTE and based on date of hire)</li>
<li>40 hours of paid inclement weather and emergency closure leave, annually front-loaded</li>
<li>8 paid holidays, plus your birthday off!</li>
<li>Free care at our clinics for team members and their families</li>
<li>And more!</li>
</ul>
*Team members are eligible for benefits on the first of the month following 30 days of employment.
 Orchid Health clinics serve Oregon’s highest need areas when it comes to healthcare, and taking this position will be making a huge difference in a community that truly needs and appreciates its healthcare providers. The schedule for this position is Tuesday - Friday (8am - 2pm or 8:30am - 2:30pm PT)
The Referral Specialist is one of the most important roles at Orchid Health. The Referral Specialist receives and documents patient referrals and follows Orchid Health’s referral process. Working with the patient/family, primary physician, Medical Director, and Clinic Healthcare Team, the Referral Specialist coordinates all patient referrals at the request of the providers, obtain/review pre-authorization/pre-certification, and coordinate communications with physician offices, companies, third-party payers and case managers; documenting appropriately within the medical record.&nbsp;
 Responsibilities:
<ul>
<li>Ensure appropriate appointments and follow-up appointments in the clinic following referral requests/visits</li>
<li>Ensure documentation from specialists/offices is obtained, filed in the chart and forwarded to companies/payers as appropriate</li>
<li>Perform patient registration tasks and procedures as requested as well as assist in the clinical area as trained and requested</li>
<li>Initiate all referral requests within 24-48 hours on business days&nbsp;</li>
<li>Return all calls promptly generally within the same day</li>
<li>Document all stages of the referral process within the EMR program (Athena) and communicate to the appropriate people regarding injury cases</li>
<li>Coordinate and schedule specialty exams within the clinic as necessary&nbsp;</li>
<li>Obtain and/or document approvals from Third-Party Payers for payment for services as directed or indicated via protocol.&nbsp;</li>
<li>Answer phone calls and act as a liaison between companies, patients, attorneys and worker’s compensation insurance companies&nbsp;</li>
<li>Request any missing documentation from providers; once received and signed off by the medical director, scan appropriate information into the EMR program (Athena)</li>
<li>Resolves pre-certification, registration and case-related concerns prior to a patient's appointment</li>
<li>Gather pertinent information from insurance carriers, financial counselors, and other ancillary staff to make certain the patient is not financially obligated for services provided</li>
<li>Use the EHR (Athena) to monitor referral orders and document all referral activities in the EHR</li>
<li>Complete prior authorizations when needed</li>
<li>Complete appropriate referral forms&nbsp;</li>
<li>Consult with providers regarding specific diagnosis information, as it relates to the referral</li>
<li>Comply with federal, state and local regulations regarding patient confidentiality and HIPAA&nbsp;</li>
<li>Ensure that the patient's primary care chart is up to date with information on specialist consults, hospitalizations, ER visits and community organization related to their health&nbsp;</li>
<li>Perform other job-related duties, as may be assigned</li>
</ul>
Required Qualifications:
<ul>
<li>Proficient at Excel, Word, and Outlook&nbsp;</li>
<li>Excellent communication and problem-solving skills</li>
<li>Excellent interpersonal skills, empathy and tact, when dealing with insurance companies, patients and other health care facilities&nbsp;</li>
<li>Able to assume the responsibilities delegated by the Manager, to provide efficient and effective coordination of care</li>
<li>Willing to adapt to changing situations and circumstances&nbsp;</li>
</ul>
Preferred Qualifications:
<ul>
<li>Bilingual in Spanish&nbsp;</li>
<li>Athena experience</li>
<li>Knowledge of medical terminology&nbsp;</li>
</ul>
Education and Experience:&nbsp;
<ul>
<li>High school diploma or GED certificate</li>
<li>Minimum of 1 year relevant healthcare experience</li>
</ul>
Work Environment:
While in the clinic, team members may be exposed to viruses, disease, and infection from patients and specimens in the working environment. Team members may be required to work for extended periods of time at a computer. Team members use standard office equipment, such as computers, phones, and e-fax.
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee may be regularly required to stand, sit, talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, telephone, and keyboard. The employee is frequently required to sit for extended periods of time. Specific vision abilities required by this job include close vision requirements due to computer work. Computer work is required for remote positions. Light to moderate lifting may be required.&nbsp;
Travel:&nbsp;
A minimum of 1-2 clinic visits per year, plus in-person meetings and events as needed.&nbsp;
Employment Offer Contingencies:
Job offers are contingent upon the successful completion of a background check and drug screening.&nbsp;
AAP/EEO Statement:
It is the policy of Orchid Health to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Orchid Health will provide reasonable accommodations for qualified individuals with disabilities.
Powered by JazzHR
qjztM0lGSG

<h3>Job Description</h3>
Job Description
We are seeking a Referral Specialist responsible for managing patient referrals to OB/GYNE Providers&nbsp;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.&nbsp;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&nbsp;&nbsp;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:
<ul>
<li>
Receiving and processing patient referrals:
Reviewing patient medical records, identifying appropriate specialists based on diagnosis and insurance coverage, and initiating the referral process.
</li>
</ul>
<ul>
<li>
Insurance verification and authorization:
Checking patient insurance eligibility, verifying benefits, and obtaining necessary prior authorizations for requested procedures or specialist visits.
</li>
</ul>
<ul>
<li>
Patient communication:
Contacting patients to explain the referral process, schedule appointments with specialists, and address any questions or concerns.
</li>
</ul>
<ul>
<li>
Provider communication:
Collaborating with referring physicians and specialists to ensure timely and accurate referral information is shared.
</li>
</ul>
<ul>
<li>
Data entry and record keeping:
Maintaining detailed patient records, including referral details, insurance information, and appointment dates within electronic health records (EHR) systems.
</li>
</ul>
<ul>
<li>
Follow-up on referrals:
Monitoring the status of referrals, and addressing any issues that may arise during the referral process.
</li>
</ul>
<ul>
<li>
Compliance with regulations:
Staying updated on insurance guidelines, healthcare regulations, and referral protocols.
</li>
</ul>
Required skills for a referral specialist:
<ul>
<li>Excellent communication skills: Ability to interact effectively with patients, physicians, and insurance companies over the phone and in person</li>
</ul>
<ul>
<li>Strong organizational skills: Efficiently managing a high volume of referrals and prioritizing tasks to meet deadlines</li>
</ul>
<ul>
<li>Medical knowledge: Understanding basic medical terminology and healthcare procedures to accurately assess referral needs</li>
</ul>
<ul>
<li>Insurance knowledge: Familiarity with different insurance plans and authorization processes</li>
</ul>
<ul>
<li>Computer proficiency: Efficiently navigating EHR systems and data entry applications</li>
</ul>
<ul>
<li>Attention to detail: Ensuring accuracy in patient information and referral documentation</li>
</ul>
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. 
<h3>Company Description</h3>
Women's HealthFirst is a large OBGYN clinic with 5 locations in Schaumburg, Bartlett, Palatine Barrington, and Hoffman Estates.

<h3>Job Description</h3>
Job Description
INTRODUCTION 
Company Overview:
BioMatrix is a nationwide, independently-owned infusion pharmacy with decades of experience supporting patients on specialty medication. Our compassionate care team helps patients navigate the often-challenging healthcare environment. We treat our patients like family and get them started on therapy quickly. We work closely with them as well as their family and their healthcare providers throughout the patient journey, staying focused on optimal clinical outcomes.
 
At the heart of our Inclusion, Diversity, Equity, &amp; Access (IDEA) philosophy is the commitment to cultivate a welcoming space where everyone’s contributions are acknowledged and celebrated. Our goal is to draw in, develop, engage, and retain talented, high-performing individuals from diverse backgrounds and viewpoints. We believe that both respecting and embracing diversity enriches the experiences and successes of our patients, employees, and partners.
Please note that this posting is not associated to any specifically available position. As we can hire for this position based on evolving business needs, applicants may be considered for future opportunities.
Schedule &amp; Location:
Monday Through Friday From 8am Pacific Standard Time to 5pm Pacific Standard Time 
It is anticipated that an incumbent in this role will work onsite in Overland Park, KS (Central Standard Time) while support Pacific Standard Time hours as noted above. Work location is subject to change based on business needs.
Job Description:
As a key member of the referral services team, a Referral Specialist will serve as the primary contact to a referral source (prescriber, provider, healthcare center, system, and/or practice), the patient for whom the referral is for, and the field-based sales representative associated with the referral source account. In this role, the Referral Specialist will be responsible for navigating a new prescription via a referral from a referral source through the necessary steps to determine whether it can be serviced in the BioMatrix network of pharmacies.
A Referral Specialist will be aligned to a geographic territory of referral sources and corresponding field-based sales team member(s). This role will work closely with data entry, reimbursement, nurse coordination, and pharmacy operations team members supporting various stages of the referral and pharmacy management processes and will understand the referral status and next steps for each referral they are responsible for supporting. The Referral Specialist will build and maintain strong and lasting relationships with key personnel within the referral source environment using effective and timely communication ensuring their patient referrals are managed through service determination in a seamless manner.
QUALIFICATION REQUIREMENTS
<ul>
<li>High school diploma or GED required</li>
<li>Minimum of one (1) year of experience managing patient referral and prescription activities or reimbursement services in infusion or specialty therapies required</li>
<li>Minimum of one (1) year of experience providing customer service in health care setting (patients and/or providers), including meeting high quality standards for services and evaluation of customer satisfaction required</li>
<li>Electronic health medical record or pharmacy patient management experience</li>
<li>Ability to multitask in a fast-paced environment</li>
<li>Proficient in medical or pharmacy terminology, written or verbal</li>
<li>Moderate skills in Microsoft Office (including Word, Excel, PowerPoint, etc.)</li>
<li>Willing to travel up to 5% of the time for business purposes (when necessary to attend meetings, conferences, seminars, etc.)</li>
</ul>
QUALIFICATIONS PREFERRED
<ul>
<li>Bachelor’s degree preferred</li>
<li>Minimum of one (1) year of experience in supporting prescriber, healthcare setting, patient, and field facing communications related to referral or prescription services in infusion or specialty therapies preferred</li>
<li>General understanding of prescription benefits, insurance/payer requirements, and verification processes</li>
<li>General experience working in a health care setting or services environment</li>
<li>General knowledge of infusion therapy process and patient needs</li>
</ul>
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
<ul>
<li>Build relationships with assigned referral sources and associated BioMatrix field representatives through communication and coordination with key personnel responsible for pharmacy referral activities within the healthcare setting</li>
<li>Serve as point of contact to referral source and keep necessary referral source personnel well informed of the status of referrals sent to BioMatrix for service</li>
<li>Follow-up with referral source, patient, and/or caregiver to collect all required information and data sets needed to support the referral process activities (including but not limited to patient demographic, pharmacy/medical benefits, clinical history, and/or prescription details)</li>
<li>Work closely with Reimbursement Specialists and conveys outcomes of benefit investigation activities with patient when it comes to patient out of pocket costs, financial responsibility, and financial assistance options for patient support consideration</li>
<li>Work closely and communicate with Nurse Coordination team for those patients who intend to move forward with service and require in-home nurse care to be scheduled and organized around prescription fulfillment and shipping</li>
<li>Work closely and communicate with Pharmacy operations team members ensuring clinical and fulfillment resources have everything they need to successfully support the on-boarding and on-going fulfillment for a new patient referral/prescription</li>
<li>Produce written documentation representing all provider, patient, caregiver, and/or field team updates and communications in necessary systems of record</li>
<li>Understand referral turn-around time, volume, and workload metrics and goals established by leadership; use goals to effectively organize referral workload and daily activities for successful outreach and completion of referral steps needed to attain service outcomes/determination</li>
<li>Support use of technology and other innovative digital channels for internal and external stakeholder communication as directed by leadership; leverage professional and effective communication skills when utilizing technology for written correspondence with these stakeholders</li>
<li>Have strong understanding of referral and prescription management processes and available services to effectively convey status, outcomes, and next steps to team members as well as referral source, patients, and field resources as expected and needed</li>
</ul>
NON-ESSENTIAL FUNCTIONS &amp; RESPONSIBILITIES
<ul>
<li>Ability to prioritize and handle multiple tasks and projects concurrently</li>
<li>General knowledge and understanding of referral profitability and reimbursement options related to referral and patient population being served</li>
<li>Support general administrative activities to navigate patient, provider, and field outreach (i.e. mailings, documentation development, scheduling of meetings/discussions, etc.)</li>
<li>Must have scheduling flexibility and be able to work overtime (from time to time upon request)</li>
<li>Careful attention to detail</li>
<li>Act as a resource to other departments and participate in department meeting and office presentations with your expertise in this area of referral services</li>
<li>Performs related duties as requested by leadership</li>
<li>Participates in quality assurance activities and audits as directed</li>
<li>Overnight travel on occasion by car and airplane</li>
</ul>
KNOWLEDEGE, SKILLS AND ABILITIES REQUIREMENTS
<ul>
<li>Excellent customer service and communication skills (both written and verbal)</li>
<li>Working knowledge of medical terminology</li>
<li>Ability to perform referral related work and tasks in an organized fashion with focus on complete information and time related deadlines</li>
<li>Ability to complete multiple projects with time sensitive deadlines</li>
<li>Ability to manage more than one priority project at a time</li>
<li>Ability to work as part of a team/committee to complete assigned tasks</li>
<li>Ability to exercise independent judgment and at times, work independently</li>
<li>Ability to enlist cooperation of other people and department in completing assigned work and projects</li>
</ul>
<ul>
<li>Ability to actively communicate, inspire and motivate peers, customers, and other stakeholders encountered in the referral services department</li>
<li>Ability to think and act strategically and proactively</li>
<li>Ability to maintain accurate records and prepare reports and correspondence related to the work</li>
</ul>
Communication Skills 
<ul>
<li>Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; demonstrates group presentation skills; actively participates in meetings</li>
<li>Written Communication - Writes clearly and informatively with professional context and direction; edits work for spelling and grammar; varies writing style to meet needs of audience; presents qualitative and quantitative data effectively; able to read and interpret written information effectively.</li>
</ul>
Computer Skills 
<ul>
<li>Become and remain proficient is all technology platforms, applications, and programs necessary to perform referral specialist duties</li>
</ul>
PHYSICAL DEMANDS AND WORK ENVIRONMENT
<ul>
<li>This position requires constant sitting with occasional walking, standing, kneeling or stooping.</li>
</ul>
<ul>
<li>This position requires the use of hands to finger, handle or feel objects and the ability to reach with hands and arms.</li>
<li>This position requires constant talking and hearing.</li>
<li>Specific vision abilities required by this job include close vision and the ability to adjust focus.</li>
</ul>
<ul>
<li>This position must occasionally lift and/or move up to 20 pounds</li>
<li>Required to move/lift physical hardware.</li>
</ul>
PHYSICAL DEMANDS 
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. If needing a reasonable accommodation within the application process, please contact the BioMatrix People &amp; Culture team at <a href="mailto:Careers@BioMatrixsprx.com" target="_blank">Careers@BioMatrixsprx.com</a> or 954.385.7322 x 1425.
 
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. 
OTHER 
<ul>
<li>Will participate in legal and ethical compliance training each year.</li>
<li>Will consistently behave in compliance with the BioMatrix, LLC’s legal and ethical policies and procedures.</li>
<li>Will abide by the policies of BioMatrix, LLC as set forth in the Compliance Manual.</li>
<li>Will not participate in any conduct considered to be unethical or illegal.</li>
</ul>

EXPECTATION FOR ALL EMPLOYEES 
Supports the organization's mission, vision, and values by exhibiting the following behaviors: integrity, dedication, compassion, enrichment and enthusiasm, places patients first, is all-in with stacked-hands, and is focused on relentless consistency wins.
GENERAL INFORMATION: 
The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required of personnel so classified.
The incumbent must be able to work in a fast-paced environment with demonstrated ability to juggle and prioritize multiple, competing tasks and demands and to seek supervisory assistance as appropriate.
Incumbents within this position may be required to assist or find appropriate assistance to make accommodations for disabled individuals in order to ensure access to the organization's services (may include: visitors, patients, employees, or others).
 
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

9,813 referral-specialist Jobs