Referral Specialist - Front Office Specialty Scheduling

Collaborates with physicians, patients, and insurance companies to pre-certify medical services and procedures in order to deliver quality medical care in the most cost effective manner. Serves as pivotal point for communication among these parties. Provides assistance in utilization management and related duties by working collaboratively with the multidisciplinary team to achieve desired clinical, service and cost outcomes. Ensures that patients presenting for treatment obtains authorization from third party payers in order to expedite the receipt of full and timely reimbursement. Provides valuable information for consideration in clinical decision-making. Promotes quality patient care and to prevent costly payment denials and reduce the institution's financial risk.

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  Patient experience with referral review and scheduling appropriately with correct providers and resources 

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  Professional Phone Skills 

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  Working as a team to cover all front office duties – faxing, managing messaging, registration check in , insurance reviews, 

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  Positive demeanor 

• →Quick learner or previous Cerner experience 

• Must have medical Office experience
• Must have experience with provider scheduling
• Cerner skills a plus 

• Requires High School diploma or equivalent.
• Requires 2-4 years of relevant experience.
• Minimum one-year medical office experience or combination of extensive customer service work experience and education in insurance verification, patient registration, and medical terminology.
• Requires working knowledge of payer billing requirements, regulations, and the third party appeal and denial process.