Referral Specialist

Job Summary:

The Referral Specialist will manage all outgoing and incoming/internal referrals from inside and outside of Upstate. Responsible for obtaining and managing any necessary prior authorizations for all outgoing referrals. Will communicate with ordering providers for any additional information or peer-to-peer reviews as required by insurance. Will process referrals and verify all necessary requirements are completed before scheduling. Document and scan all communication with referral offices and communication with the patient.

Will also work closely with ambulatory offices and assist them in finding all necessary medical records. The referral specialist will answer calls and e-mail correspondents about pending/ready to schedule referrals with the referring providers. Accepts assignments to other areas as needed.

Associate's degree and two (2) years relevant patient financial/insurance services experience in a healthcare related setting or equivalent combination of education and experience required. Working knowledge of medical terminology, medical billing/insurance requirements, familiarity with medical coding, and excellent written/oral communication skills required. Computer skills and keyboarding are necessary. Ability to maintain good public relations with patients, visitors, co-workers and other individuals.

Prior working experience in ambulatory patient care administrative functions including obtaining referrals and insurance authorizations, managing EPIC referral work queues, communicating with outside agencies such as insurance carriers, billing companies and/or other support agencies preferred. Working knowledge of computer systems such as Epic, Word, Outlook, etc. preferred.

M-F Days

This position has been reposted due to a change in title.

This is located in the Nappi building

Recruitment Office:
Human Resources