Referral Specialist - First Shift

Referral Specialist - Full Time First Shift

Join to apply for the Referral Specialist - Full Time First Shift role at Valley Health.

The Insurance and Referral Specialist coordinates the front end of the revenue cycle by processing pre-registration, registration, demographic and financial verification activities. The specialist analyzes insurance payor plans and verifies eligibility through Epic’s RTE platform or third‑party websites, and documents eligibility responses in the patient’s medical record. They coordinate with verification of insurance benefits for all patients within 48 hours of seminar attendance, call patients within 72 hours of the seminar to communicate results of benefits verification and to schedule an initial consultation appointment.

The specialist counsels patients on self‑pay options and financing, and meets with each patient at the end of the initial consultation to discuss insurance, clinical requirements and the process to surgery. They track patient status and enter all insurance and relevant data in the tracking tool. They collaborate with bariatric patient navigators and other team members to ensure clear communication on insurance requirements, referring reasons, and patient preferences.

They track referrals, respond to referring providers, contact referred patients to initiate care, and ensure referrals are completed properly.

• Process pre-registration, registration, demographic and financial verification activities for patients.
• Analyze insurance payor plans and verify eligibility via Epic’s RTE platform or third‑party websites; document eligibility responses in the patient record.
• Coordinate insurance verification within 48 hours of seminar attendance and contact patients within 72 hours to communicate results and schedule the initial consultation.
• Counsel patients on exclusions for self‑pay and financing options; discuss insurance and clinical requirements and the surgical process at the end of the initial consultation.
• Track patient status and enter insurance data in the tracking tool; collaborate with bariatric navigators and other team members to ensure clear communication on insurance requirements and patient preferences.
• Track referrals, respond to referring providers, and initiate care with referred patients to ensure referrals are completed properly.

• Education:
  
  High School Diploma or GED required. Five years medical clinic experience may be accepted in lieu of diploma.
• Experience:
  
  Five years customer service-related experience required.
• Experience working in a medical clinic setting is required.
• Experience with ICD and CPT coding is required.
• Three years working with insurance companies and obtaining authorizations is preferred.
• Strong computer skills required.
• Ability to demonstrate excellent judgment; excellent verbal and written communication skills; ability to accurately document patient status; ability to manage multiple tasks simultaneously; ability to function as a team member and promote teamwork.
• Knowledge of EMR systems preferred.

• A Zero‑Deductible Health Plan
• Dental and vision insurance
• Generous Paid Time Off
• Tuition Assistance
• Retirement Savings Match
• Employee Assistance Program to support emotional wellbeing
• Membership to Healthy U:
  An Incentive‑Based Wellness Program

Valley Health also offers a health savings account and flexible spending accounts for childcare, life insurance, short‑term and long‑term disability, and professional development. Additional employer perks include discounts to on‑campus dining and other benefits. See  for full details.