What are the responsibilities and job description for the Medical Referral Specialist position at Trinity Employment Specialists?
Medical Referral Specialist
Full Time | Monday - Friday | 8:00 AM - 5:00 PM | $17.00-$20.00/hour
Referral Specialist Job Duties/Requirements:
Scheduling referrals for patients, providers, pre-authorizing & pre-certing tests/procedures
Reviews clinical data to report medical necessity to insurance companies
Knowledge of clinical terminology, insurance billing, procedural and diagnosis coding, federal and state insurance regulations, and HIPAA privacy standards is strongly preferred.
Experience with various insurances required; experience with Medicare/Medicaid a plus
Acute healthcare knowledge and ability to evaluate clinical data to acquire pre-authorizations and referrals is preferred.
Knowledge of third-party reimbursement regulations is preferred.
Qualifications:
Demonstration of strong analytical skills and problem-solving abilities. Strong teamwork skills and the ability to effectively communicate with all management levels.
Excellent customer service skills and must be able to work independently
Knowledge of clinical terminology, insurance billing, procedural and diagnosis coding, federal and state insurance regulations and HIPAA privacy standards is strongly preferred.
Proficiency in Microsoft Office applications required
Education:
High school graduate or GED required
Work experience:
Minimum of two years’ experience in a healthcare or clinical setting