Patient Access Center - Referrals Specialist

Job Description

Job Description

COMMUNITY HEALTH :

Community Health is a primary care network that provides nationally-recognized programs, a focus on wellness, dental, behavioral health and pediatric specialties, walk-in Express Care, a culture of community and quality health care that almost everyone, insured or uninsured, has come to depend on. As an equal opportunity employer, we offer a team-oriented, collaborative work environment for close to 400 employees at eight different locations in Rutland and southern Addison counties.

ABOUT THE ROLE :

The referral specialist obtains reviews and inputs insurance authorization and referrals for patient services. The referral specialist also ensures payment for services by verifying benefits with insurance providers.

FUNCTIONS OF THE POSITION :

• Reviews providers order to ensure referrals are in place prior to service.
• Receives, maintains, and notes in the system all referrals for services.
• Runs reports on a scheduled basis to obtain accuracy and to keep providers and staff informed of referrals / testing.
• Interviews and assists patients with authorization documents as needed.
• Maintains appropriate reports according to Community Health policy, state and federal requirements.
• Monitors and tracks patient authorizations, informing supervisor of any expired dates if applicable.
• Identifies issues and notifies appropriate staff and or providers.

SKILLS REQUIRED FOR SUCCESS :

HOW WE SUPPORT YOU :