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Referral Specialist - Spokane, WA
ABC Medical Spokane, WA
$39k-47k (estimate)
Full Time | Wholesale 2 Weeks Ago
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ABC Medical is Hiring a Referral Specialist - Spokane, WA Near Spokane, WA

Work Location:

Spokane, WA - onsite Monday-Friday; Hours: 8:30am-5pm PST

Responsibilities:

The Referral Specialist is responsible for verifying, obtaining, reviewing, and accurately determining that all medical documentation received from physicians or referral sources meet all local coverage determinations and regulatory requirements. The Referral Specialist is responsible for the Pre-authorization functionality.

  • Examine documents to verify required compliance, completeness, and accuracy of data.
  • Confer with document originator and approvers to resolve identified discrepancies.
  • Contact insurance companies to confirm insurance coverage and eligibility of products.
  • Obtain prior authorization and/or referrals.
  • Appropriately update customer database when obtaining documents and pre-authorizations.
  • Appropriately update document databases, and corresponding files.
  • Generate communication to the appropriate personal on new and revised documents including Pre-authorization request.
  • Regularly communicate with Health Care Providers, Commercial and Government Payors, and Sales Managers.
  • Achieve defined service level agreements.
  • Communicate Payor requirements as they are discovered.
  • Adheres to all HIPAA guidelines/regulations.

Minimum Qualifications:

  • High School Diploma or equivalent work experience
  • 2 years of work experience
  • Basic understanding of payor guidelines
  • Analytical skills required, attention to detail, and organized
  • Basic Microsoft skills.
  • Ability to work well in a team environment

Preferred Qualifications:

  • Previous DME experience

Here's what we have to offer:

  • Variety of Medical, Dental and Vision Insurance Plans
  • 401k Plan with Company Match
  • PTO and Paid Holidays
  • EAP
  • Employee Discounts

The anticipated base salary range for this position is $18.00-$22.00. The actual salary varies based on applicant's location, education, experience, skills, abilities, and other legitimate business factors. The Company also provides a unique Benefit of Employee Share Ownership Program (BESOP) program.

  • The Company's health and welfare benefits include: medical, prescription, dental, vision, spending/savings accounts, disability, statutory leaves/disability programs, accident, life, wellbeing, and voluntary benefit programs.
  • The Company's 401(k) Retirement Savings Plan includes: vesting and eligible participants "safe harbor" matching contributions.
  • The Company's paid time off benefits include: 8 paid holidays and paid vacation based on length of service and exempt/non-exempt status.

To make life more rewarding and dignified for the people who use our products and services.

Job Summary

JOB TYPE

Full Time

INDUSTRY

Wholesale

SALARY

$39k-47k (estimate)

POST DATE

04/20/2024

EXPIRATION DATE

06/19/2024

WEBSITE

abc-med.com

HEADQUARTERS

SPRINGFIELD, VA

SIZE

50 - 100

FOUNDED

2003

CEO

MARGARET C CASCIANO

REVENUE

$10M - $50M

INDUSTRY

Wholesale

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About ABC Medical

The healthcare industry is constantly changing... and so is ABC Medical! Competition and change will only make our company stronger and more creative each day. As one of the nations' leading urological supply providers, ABC Medical serves as a one-stop shop with a comprehensive line of medical supplies that includes catheters, ostomy and wound care supplies. Over 10+ years of service, we have constantly adapted from being just your urology supply provider to becoming the first and only urology supply provider in the industry committed to adaptive sports, believing we can and will make a differ...ence in the communities we serve. Each year, we contribute thousands of dollars and hours to athletes and adaptive sports organizations because we believe that being active leads to a healthier and happier lifestyle. In addition to providing the best-in-class customer service for urological supplies, we strive to be our customers' and their families' primary resource of information. Check our website at www.abc-med.com, follow us on social media and you'll see why! (Facebook: www.facebook.com/myabcmedical, @myabcmedical) If you do use urological supplies on a regular basis, give ABC Medical a call today. Our caring and knowledgeable team members will assist you with any questions you might have from insurance coverage to products and will take care of all your medical supply needs, so you can enjoy the quality life you deserve. Transitioning is worry free since our experienced team will take care of almost everything. We'll enroll you in our FREE catheter sampling program, so you never worry about running out of catheters-- we'll call your current provider to let them know you are working with ABC Medical and we'll call your doctor to get your medical records-- all you have to do is make one 5 minute call... today. Call today and allow us to help you Adapt. Believe. Compete. in life. More
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