Referrals Specialist

Job Description

Job Description

SSM Health Dermatology's mission is to strive as a team for excellence by providing the most comprehensive, patient-centered care every day. We are looking for a Referrals Specialist to contribute in their own unique way to our Company’s exceptional services and performance for our clients.

Objective:

Under the direct supervision of leadership, the Referral Specialist is responsible for ensuring that a patient’s insurance allows them to access the services of the specialist’s health care provider.

Qualifications:

• Five plus years of medical experience and or associate degree or related education.
• Valid driver’s license and auto insurance.
• Understanding of insurance benefits.
• Educate patients regarding their referral authorizations.
• Associate degree or related education.

Job Duties:

• Managing all incoming referrals requests.
• Verify insurance eligibility of the patient.
• Obtain authorizations on all insurance carriers requiring authorization prior to the visit.
• Set up referral appointments with Providers and/or diagnostic facilities as well as process any applicable orders or records.
• Contact patients with appointment time and pertinent information.
• Verify weekly that appointments have been scheduled and log information into all applicable systems/processes.
• Complete required notifications to patients and assure compliance with associated processes.
• Review daily DAR to assure all scheduled patients have appropriate coverage for procedures scheduled as well as any required referrals.
• Will work collaboratively with billing department and front desk to ensure there is a complete understanding related to patient’s eligibility for treatment.
• Work and distribute all incoming faxes.
• Drive to satellite clinics as assigned.

Education:

• Associate degree or related education preferred.
• High school education or equivalency required.

Physical Demands

• Sitting
• Standing
• Typing
• Lifting up to 25 pounds