Referral Specialist at TYLER HOLMES MEMORIAL HOSPITAL

Winona, Mississippi, United States -

Full Time

Start Date

Immediate

Expiry Date

13 May, 26

Salary

0.0

Posted On

12 Feb, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Clinical Competency, Communication, Insurance Verification, Authorization, Appointment Scheduling, EHR, Patient Interaction, Documentation, Team Collaboration, Problem Solving, Computer Skills, Professional Development, Conduct, Grooming, Attendance

Industry

Hospitals and Health Care

Description

Description Primary Job Function: A Referral Specialist processes insurance pre-verification for hospital admissions or specialty service office visits. Gathers pertinent information from patients, insurance carriers, financial counselors, and other staff to confirm the patient's financial obligations for services. acts as a liaison between hospitals, clinical staff, health plans, providers, and patients to process referrals. Verifies insurance coverage and obtains required authorizations. Additionally, Referral Specialist resolves pre-certification, registration, and case-related issues. Documents referrals, communications, actions, and other data in an information system. Generates and distributes all applicable forms, notifications, and paperwork. Essential Job Functions: Works in our EHR to receive referrals from providers. Process referrals according to the orders. Obtains prior authorization for payment from the patient's insurance4 company. Secures appointment with other providers, lab, radiology, etc.. Communicates with the patient to verify appointment time and any information they may need to take to the appointment. Communicate effectively with all providers and office staff to ensure that everyone is aware of necessary information related to patient care. Requirements Knowledge, Skills and Abilities: Demonstrates clinical competency as identified by certifications and training. Assumes responsibility for own continued personal and professional development. Appropriate manner, conduct y and grooming. Ability to work cooperatively and communicate effectively. Good health and consistent attendance Working knowledge of basic computer skills. Education and Experience: Current LPN license required Clinic experience preferred Essential Job Duties: Receive referrals through the HER from providers at THMH. Verify insurances by using various websites, phone and fax. Establish appointments with appropriate facility, office, physician. Notify patient of appointment time and any additional information that is needed for procedure/appointment.

Responsibilities

The Referral Specialist processes insurance pre-verification for hospital admissions and specialty service visits, acting as a liaison between various parties to confirm financial obligations. They also verify insurance coverage, obtain authorizations, and document all relevant information in an information system.