Catholic Health Initiatives Referral Specialist - The Woodlands in THE WOODLANDS, Texas

Referral Specialist - The Woodlands

Description

Job Summary:

The Referral Specialist works with patients requiring a referral, to ensure patient’s referral needs are fulfilled for specialty service office visits. Processes referrals, authorizations and pre-certifications for patients, to ensure timely reimbursement.

Essential Duties:

  • Gather, verify, and process referrals, authorizations, and pre-certifications by working closely with physician(s), patients, and payers.

  • Communicate detailed information and answers patients' questions regarding their health care plan; provide answers to billing and insurance clarification questions.

  • Set up appointments, coordinate clinic visits, and any special arrangements such as transportation, interpreter services, specialty care, etc.

  • Coordinate flow of information between medical clinic and referral authorization department to secure a valid referral for clinic patient.

  • Enter referrals, documents communications and action into the system, as appropriate.

  • Notify physician(s) and patient when referral is denied, or if additional information is needed.

  • Develop and maintain database of referral physician offices preferred by each physician within the clinic.

  • Assist Practice Manager with complaint resolution and solutions related to patient referrals.

  • Perform other duties as assigned by the practice manager or physician.

Qualifications

  • High school diploma or equivalent required.

Job Administrative and Clerical

Primary Location TEXAS-THE WOODLANDS-ST LUKE WOODLANDS

Daily Schedule M-F 8-5pm

Scheduled Hours per 2-week Pay Period 80

Weekends Required None

Req ID: 2017-R0129972