Referral and Insurance Specialist - Orthopedic Specialists of Midlothian

Referral & Insurance Specialist Orthopedic Specialists of Midlothian

The Referral and Insurance Specialist obtains authorizations from insurance companies for referrals to physicians and/or procedures/testing. Verifies eligibility/coverage for referral via phone/fax/Internet. Schedules appointments for testing at medical facilities or appointments with physicians. Gathers charge information and enter all pertinent charge and patient demographic information into computer billing system. Posts all payments and makes daily deposits. Assists patients regarding billing questions and account balance resolution. Promotes a positive and helpful climate for good interpersonal and interdepartmental relationships.

Essential Functions:

• Obtains authorizations from insurance companies for referrals to physicians/medical facilities and/or procedures/testing.
• Schedules appointments for testing at medical facilities or appointments with physicians.
• Verifies eligibility/coverage for referral/testing via phone/fax/Internet.
• Investigates billing problems and denials.
• Notifies patients of referral process whether authorized or denied in a timely manner. Give patients instructions.
• Performs data input of patient and/or insurance changes and corrections to ensure current and accurate information in billing system.
• Answers the telephone, take messages, schedule appointments and greet patients as needed.
• Prepares patient charge encounter forms for each day and makes new or updates patient chart as needed.
• Oversees waiting area, coordinate patient movement, and reports problems or irregularities.
• Screens visitors and respond to routine request for information.
• Organizes and files progress notes, testing reports, and other forms necessary for chart completion. Assists with appropriate filing of patient charts as needed.
• Collects patient responsibility balances and copayments as needed. Balance money collected daily.
• Opens and distributes daily mail as needed
• Obtains authorizations from insurance carriers or pharmacy benefit managers for medications.
• Collects all daily charge slips from the physician and reconciles the number of charge slips and their totals
• Applies all payments to the appropriate patient account by posting each into the computer billing systems
• Inputs all charge information into the online billing system
• Assists with coding and error resolution as well as requesting needed information by working with the physician offices
• Works with patients in resolving billing questions and patient account resolution
• As applicable, reviews information to make determination on the appropriate course of action for the patient, makes referrals to the local DSS office as appropriate.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Education:

High School Diploma or GED (required)

Licensure/Certification:

None

Experience:

2-3 years of experience in a related medical field with experience in processing referrals (preferred)

Range:

Minimum: $18.11

Maximum: $27.17

Bon Secours is an equal opportunity employer.

As a Bon Secours associate, you're part of a Mission that matters. We support your well-being personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.

• Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
• Medical, dental, vision, prescription coverage, HSA/FSA options, life insurances, mental health resources and discounts
• Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
• Tuition assistance, professional development and continuing education support

Benefits may vary based on the market and employment status.

Department:

Bon Secours Orthopedic Specialists of Petersburg