Medical Referral Specialist

Job Description

Job Description

Medical Referral Specialist:

We currently have an exciting new opportunity for a full-time Medical Referral Specialist in our busy multi-specialty Clinic. The Medical Referral Specialist coordinates patient access to specialists by verifying insurance, obtaining pre-authorizations, scheduling appointment, tracking referrals in EHRs, and acting as a liaison between patients, providers, and insurers, ensuring continuity of care and adherence to insurance policies while maintaining accurate records and communicating progress. Key duties involve insurance verification, coordinating care, patient education, and administrative tasks like documentation and follow-up, requiring strong communication, organization, and knowledge of medical terminology and insurance processes.

We are in search of a team player that has the following:

Responsibilities:

• Insurance & Authorization: Verify patient eligibility, benefits, and obtain pre-authorizations or pre-certifications from insurance companies.
• Coordination: Act as liaison between patients, referring to providers, specialists and health plans.
• Scheduling: Schedule appointments with specialists, DME providers, or for diagnostic tests. 
• Tracking & Documentation: Maintain meticulous records in the Electronic Health Record (EHR), track referral status, and close the referral loop.
• Patient communication: Educate patients on their healthcare plan, confirm appointments, and provide reminders.
• Follow-up: Monitor referral progress, ensure timely completion, and follow-up with all parties.
• Reporting: Generate reports on referral trends and assist with quality improvement initiatives.
• Performs other duties as assigned.
• Additional Duties: May be assigned additional duties or responsibilities based on the needs of the organization.

Requirements:

• High school diploma or equivalent required. 
• Minimum of 3 to 5 years of experience working in a medical setting. 
• Strong knowledge of medical terminology.
• Good command of English oral and written. (Bilingual Spanish preferred)
• Knowledge of EMR, Microsoft Office or other computer systems. 
• Leadership, problem-solving, and conflict resolution.
• Excellent communication and interpersonal skills
• Current CPR/First Aid card.
• Current TB negative test.
• Excellent customer service skills. 
• Attention to detail and accuracy.
• Self-motivated, responsible, reliable and honest.
• Must be a team-player who interacts well with others.

We offer an exceptional benefits package, which includes medical, dental and vision. Our team of highly qualified physicians and staff will also provide you with exceptional training and mentorship for your career. 

If you want to be a part of our team and make a difference in the lives or our patients and their families, please contact us at View email address on us.fitly.work or you may call us at View phone number on us.fitly.work.