What are the responsibilities and job description for the Medical Referral Specialist position at Childrens Medical Group PC?
Description
This position is a full-time Referral Specialist role located within our Johns Creek location.
Duties include:
- Processing incoming and outgoing calls to secure referrals and authorizations from providers and insurance companies
- Perform online authorizations of services
- Provide support to providers regarding utilization and authorization of referrals
- Contact providers with authorization, denial, and appeals process information as necessary
- Generate specialty referrals for members as requested by primary care physicians
- Assuring all pertinent documentation is forwarded to the provider
- Develop and maintain excellent record keeping systems
Requirements
The Job requirements are as follows:
- Must be able to execute above job description
- 2 yrs work experience in healthcare referral & referral tracking preferred
- High school diploma or equivalent
- Must have an understanding of pediatric healthcare ICD10 and CPT codes
- Detail oriented and organized
- Critical decision making and problem solving skills
Shift: Monday-Friday, 8:00am-5:00pm with 1-hr lunch
Benefits include Medical, Dental, Vision, 401k Match, Medical & Dependent Care FSA, STD, and annual uniform allowance.