The Role
Coordinate and process patient referrals to specialists, verify insurance eligibility, maintain referral documentation, follow up with clinics and patients, obtain prior authorizations, assist with patient calls, and complete assigned Relias training.
Summary Generated by Built In
As a Referral Representative, you will act as a liaison between patients, our providers, and specialty sites; check patient eligibility and maintain accurate and timely documentation. This position will report to the Assistant Site Operations Director.
JOB RESPONSIBILITIES:
- Organizes appropriate referrals to specialists and remains a resource for patients and staff regarding the referral agencies and process.
- Checks Medicaid, Medicare, and private insurance websites for patients provider coverage.
- Completes referral information for patients as requested by the Providers.
- Maintains and updates referral resource binder.
- Manages open referral orders by finding documents and follows up with all parties involved.
- Assists with patient phone calls and questions.
- Follows up with specialty clinics to coordinate patients medical information flow.
- Maintains accurate and timely documentation.
- Obtain prior authorization for specific testing.
- All HealthLinc staff is committed to engage in quality improvement initiatives that align with and support Patient-Centered Medical Home (PCMH).
- Perform other duties as assigned.
REQUIRED QUALIFICATIONS:
Education/Training
- High school diploma or equivalent
- Some college (not required but highly preferred)
Experience
- At least 1-2 years of experience in a medical administrative position
- At least 1-2 years of experience in a customer service position
Skills/Job Requirement
- Strong organizational and time management skills
- Strong customer service skills
- Proven ability to work well in a team environment
- Excellent verbal and written communication skills
- Proven experience with basic medical terminology (not required but highly preferred)
- Ability to follow HealthLinc policies and procedures
Technology Skills
- Operate a multi-line phone system and other office equipment including printers, fax machines, etc.
- Basic computer skills (Microsoft Office, EHR, online sources, etc.)
DIRECT SUPERVISION:
- N/A
REQUIRED TRAINING:
- All assigned Relias training
Skills Required
- High school diploma or equivalent
- Some college
- 1-2 years medical administrative experience
- 1-2 years customer service experience
- Strong organizational and time management skills
- Strong customer service skills
- Ability to work well in a team environment
- Excellent verbal and written communication skills
- Proven experience with basic medical terminology
- Ability to follow organizational policies and procedures
- Operate multi-line phone system and office equipment (printers, fax)
- Basic computer skills including Microsoft Office and EHR
- Complete assigned Relias training
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The Company
What We Do
HealthLinc is a not-for-profit Federally Qualified Health Center providing comprehensive primary medical, dental, optometry, and behavioral health services to all individuals, regardless of their ability to pay, with a mission to create healthy communities.
