Referral Services Assistant

Referral Services Assistant

Referral Services Assistant Location: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. Hours: Associates will be assigned a shift between 9:30 AM and 7:30 PM Eastern time. Please adjust for your time zone. This is a virtual role but associates must report to the nearest office location for any internet or equipment issues, or performance issues.

The Referral Services Assistant is responsible for providing support to clinical team to facilitate the administrative components of clinical referrals for case management or disease management services to include home health, nutritional counseling, etc.

How you will make an impact:

• Initiates and manages clinical referrals for participants registered in a disease management or health program.
• Acts as a liaison between hospital, health plans, physicians, patients, vendors and other referral sources.
• Reviews referrals for completeness and follows up for additional information.
• Assigns referrals to staff.
• Verifies insurance coverage and obtains authorizations from insurance plans.
• Maintains database of insurance companies for verification of coverage, accepted plans, and requirements for patient eligibility.
• Contacts physician offices to obtain demographic information or related data.
• Enters referrals and documents communications in system.
• Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers.
• Additional expectations to include but not limited to: Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; strong verbal and written communication skills, both with virtual and in-person interactions; attentive to details, critical thinker, and a problem-solver; demonstrates empathy and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts.
• Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary.
• Performs other duties as assigned.

Minimum Qualifications:

• Requires a HS diploma or equivalent and a minimum of 1 year of experience in a healthcare environment; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Travels to worksite and other locations as necessary.
• Customer service experience is strongly preferred