Referral Specialist

Job Summary and Responsibilities

You have a purpose, unique talents and now is the time to embrace it, live it and put it to work. We value incredible people with incredible skills – but your commitment to a greater cause is something we value even more. This is the heartbeat of our organization and your time will be spent in a supportive, team environment with resources to help you flourish and leaders who care about your success.

 

Referral Specialist answers telephone inquiries from consumers regarding physician referrals and community service referrals. Assists with physician appointments when indicated. Supports call center functions by researching and maintaining database utilized by staff. Obtains Insurance authorization for patient referrals from primary care to specialty care. Collect insurance information and verify patient eligibility, benefits and provider's network status. Using multiple insurance payor platforms. Confirms with the specialty provider that insurance is accepted, whether patients' conditions can be treated, and the next available appointment as appropriate per referral type. Performs inbound and outbound calls related to referrals and find-a-provider service lines documenting appropriately.

Job Requirements

In addition to bringing humankindness to the workplace each day, qualified candidates will need the following:

 

• High School Diploma/G.E.D. Required
• Two years related customer service experience Required
• Prior experience in a hospital admissions department, physician office, or similar healthcare setting
• Able to use Windows software to input information into computer, including strong word processing skills
• Demonstrates excellent customer service skills.
• Understand medical terminology and basic health care insurance requirements
• Typing skills 35 wpm minimum
• Referral processing experience preferred
• Insurance experience preferred

Where You’ll Work

CommonSpirit Medical Group (CMG) offers providers a true opportunity to live their calling to care while experiencing the support of a built-in comprehensive network, vast resources, professional growth, trusted leadership, generous benefits and an amazing quality of life with locations in Colorado, Kansas and Utah. CMG is proud to connect providers and consumers through state-of-the-art technology, clinical resources and professional expertise to help people live healthier. Our coordinated services represent a full continuum of care – from preventive and early diagnoses to leading-edge treatment and life-saving critical care. CMG’s ability to deliver better health care value is the direct result of combining the best clinical tools, shared resources and medical expertise with a patient-centered approach that emphasizes CommonSpirit Mountain Region’s mission and commitment to quality, compassion and service.