Referral Specialist

Job Summary
We are seeking a detail-oriented and organized Referral Specialist to join our healthcare team. The ideal candidate will be responsible for managing referral processes, verifying insurance, and ensuring accurate documentation within a fast-paced medical environment. This role is essential in facilitating seamless communication between providers, patients, and insurance companies, ensuring compliance with healthcare regulations such as HIPAA. Prior experience in medical office administration, medical coding, or managed care is highly valued. The Referral Specialist will play a key role in maintaining efficient office operations and supporting patient care coordination.

Responsibilities

• Manage and process patient referrals efficiently, ensuring timely submission and follow-up.
• Verify insurance coverage and benefits using insurance verification protocols to ensure authorization for services.
• Maintain accurate medical records, including documentation of referrals, authorizations, and patient information in compliance with HIPAA standards.
• Utilize CPT coding, ICD-9, ICD-10, and ICD coding to accurately code procedures and diagnoses for billing purposes.
• Collaborate with healthcare providers to obtain necessary documentation and ensure proper coding for insurance claims.
• Assist with medical office tasks such as appointment scheduling, data entry, and maintaining organized files.
• Ensure compliance with all healthcare regulations and confidentiality standards related to medical records and patient information.
• Communicate effectively with patients, providers, and insurance companies to resolve issues related to referrals or claims processing.

Skills

• Strong knowledge of managed care processes and insurance verification procedures.
• Experience working in a medical office setting with familiarity in medical terminology and medical records management.
• Proficiency in CPT coding, ICD-9, ICD-10, and ICD coding systems for accurate billing and documentation.
• Understanding of HIPAA regulations to maintain patient confidentiality and data security.
• Excellent organizational skills with the ability to manage multiple tasks efficiently in a fast-paced environment.
• Office experience with proficiency in electronic health records (EHR) systems or similar software is preferred.
• Effective communication skills to liaise between providers, patients, and insurance representatives confidently.
• Prior dental office experience or familiarity with dental insurance processes is a plus but not required. This position offers an opportunity to contribute significantly to healthcare operations while developing your expertise in medical billing, coding, and insurance processes within a supportive team environment.

Pay: $17.00 - $18.00 per hour

Work Location: In person

Salary : $17 - $18