Referral Specialist

Location

Minot, ND | United States

Job description

Overview

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S., from clinics and hospitals to home-based care and virtual care services, CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources, CommonSpirit is committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen, both inside our hospitals and out in the community.

CHI Minot Medical Plaza is looking for a Full Time Referral Specialist to join the team!

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.

What You'll Do:

• 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.

High school diploma or equivalent required

2 years of progressively responsible related experience in a healthcare environment required.

Job tags

Salary