Referral Specialist Resume Samples
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Referral Specialist Resume Samples
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T Fisher
Tito
Fisher
4118 Konopelski Streets
New York
NY
+1 (555) 368 3665
4118 Konopelski Streets
New York
NY
Phone
p
+1 (555) 368 3665
Experience
Experience
San Francisco, CA
Referral Specialist
San Francisco, CA
Auer, Sanford and Hansen
San Francisco, CA
Referral Specialist
- Provides input to Team Lead and Supervisor/Manager regarding improvements to operating practices
- Establish and maintain relationships with identified service providers
- Works with manager to maintain files, coordinates patient care as it relates to quality assurance and utilization review
- Notifies case management about interactions with insurance companies regarding services. Manages denials or potential denials as described by insurer
- Applies principles of specific managed care product to each task to insure contractual compliance
- Reviews and manages Epic Work queues and other information pathways to maintain accurate authorization requests
- Utilizes computer resources to determine provider networks
Houston, TX
Metcare Referral Specialist of Plantation
Houston, TX
Reinger Group
Houston, TX
Metcare Referral Specialist of Plantation
- Ensure consultation reports are received from the consulting provider to maintain continuity of care
- Proficient with Microsoft Office applications including Microsoft Word, Excel and Outlook
- Proficient with medical terminology and familiar with CPT-4 and ICD-9/10 coding
- Self-motivated and committed to achieving best results
- Other duties as assigned
- Demonstrate respect for the privacy and confidentiality of patient’s protected health information
- Partners with Network Development to ensure specialist network is adequate for the geography and escalates accordingly when network adequacy impacts access to care
present
San Francisco, CA
Referral Specialist Team-frontline Leader
San Francisco, CA
Smith Inc
present
San Francisco, CA
Referral Specialist Team-frontline Leader
present
- Provide managerial oversight of Humana At Home Associate
- Develop plan of action for process improvement
- Provide managerial oversight of Humana At Home Associates
- Monitorand audit staff performance
- Monitor and audit staff performance
- Participate in the promotion of the multi-disciplinary healthcare team
- Proficiency with all Microsoft office to include: PowerPoint, Visio, CGX, hCAT, auto dialer
Education
Education
Bachelor’s Degree in Nursing
Bachelor’s Degree in Nursing
University of Tennessee
Bachelor’s Degree in Nursing
Skills
Skills
- CTG is a strong advocate of workforce diversity. EOE/AA. Minority/Female/Disability/Veteran
- Proficient computer navigation skills, with basic/advanced Microsoft Office/Outlook and intra/internet experience
- Able to take and follow through with delegated tasks and accountability
- Strong attention to detail
- Detail oriented
- Hiring manger will review resumes beginning May 9, 2017 and will start scheduling interviews at this time. This is a temp-to-perm position for the right candidates!
- Great interpersonal skills
- Excellent communication skills (written and verbal)
- Strong communication skills
- Highly organized
15 Referral Specialist resume templates
Read our complete resume writing guides
1
Referral Specialist Resume Examples & Samples
- Document per protocol and communicate pertinent information to designated person and/ or persons
- Work collaboratively with other members of the clinical leadership team
- Intermediate to advanced computer skills and knowledge of Microsoft Word and Excel
- Solid interpersonal and professional verbal and writing communication skills
- Ability to work a full time (40 hours minimum) flexible work schedule to include some weekends
- Adaptable with the ability to thrive in a fast paced environment
2
Referral Specialist Frontline Leader Resume Examples & Samples
- 3-5 plus years of professional experience
- Ability to meet or exceed business goals while providing perfect member experience
- Ability to develop, mentor and train associates at all levels. (New associates and seasoned associates)
- Ability to review current processesand provide modification as the business needs change and present the changesto the business leaders
- Ability to interact effectively with multi-disciplinary team members
- Proficiency with all Microsoft office to include: PowerPoint, Visio, CGX, hCAT, auto dialer
- Previous call center leadership experience
- Bilingual-Fluent in Spanish and English
3
Referral Specialist Snp Resume Examples & Samples
- Participate in the promotion of the multi-disciplinary healthcare team
- Additional responsibilities as deemed appropriate by Humana At Home Leadership
- Ability to multi-task without losing sight of accuracy & quality
- Associate’s degree or equivalent from two-year college or technical school OR six months to one year related experience and/or training
- Bilingual (English/Spanish); speaking, reading, writing, interpreting and explaining documents in Spanish and English
- Experience with healthcare experience
- Experience in customer service
- Experience with outbound calls (6 months outbound call center experience preferred)
4
Referral Specialist Team-frontline Leader Resume Examples & Samples
- Provide managerial oversight of Humana At Home Associate
- Monitorand audit staff performance
- Develop plan of action for process improvement
- Oversightof daily operations
- Ensure compliance and accuracy regarding program design and implementation thru monitoringand reporting of associates
- Work collaboratively with other members of the leadership team and comply with policy and procedures, performance and reporting standards as defined by Humana At Home
- Additional responsibilities as deemed appropriate by Humana At Home leadership
- Previous call center leadership experience or 1-2 years mentorship and training among peers related to technological systems and various business lines
- Ability to work independently and demonstrate critical thinking skills
- Promote a positive team attitude
- Excellent keyboard, web navigation skills and proficiency with Microsoft office product such as Word, Excel and Visio
- Flexible scheduling availability, with evenings and occasional weekends as business needs dictates
- 1-3 plus years of previous management/supervisor level experience
- Ability to review current processes and provide modification as the business needs change and present the changes to the business leaders
5
Referral Specialist Dual Demo Resume Examples & Samples
- Relate to a production environment and understand process flows
- High level of detail and organization skills
- Skills to use a variety of electronic information processing tools and multiple software programs
- Ability to establish priorities, work independently and proceed with objectives without direct supervision
- Ability to work a full time (40 hours minimum) work schedule that may vary between 8:00 AM and 7 PM Monday through Friday to include some weekends
- Experience working with the senior adult population
- Experience with healthcare experience. Experience in customer service
- Experience in routine telephonic calls
- Experience with outbound calls (6 months outbound call center experience preferred) Adaptable with the ability to thrive in a fast paced environment
- Bilingual (English/Spanish); speaking, reading, writing, interpreting and explaining documentation in Spanish and English. Reporting Relationships
6
Information & Referral Specialist Resume Examples & Samples
- Complete intake process for requestors for Louisiana long-term care programs
- Community Choice Waiver
- Long Term Personal Care Services
- Adult Day Health Care Waiver
- Program for All Inclusive Care for the Elderly
- Complete Level of Care Eligibility Tool (LOCET) and other applicable assessments
- Handle incoming and outgoing phone calls to waiver and long term-personal care services (LT-PCS) requestors and recipients
- Use Xerox and DHH databases to input and update requestors and recipients information and track application process for DHH long-term program options
- Perform post assessment tasks related to LOCET mailing and follow-up for requestors
- Make appropriate referrals for non-OAAS community services
- Handle TTD/TTY (telecommunications for the hearing impaired) assistance calls
- Provide prompt, professional customer service to ensure that all necessary information is covered and gathered from requestors in a clear, consistent, and professional manner
- Bachelor’s Degree in a human services field with a minimum of one year experience in social and/or human services, preferably working with the elderly and disabled adult population
- Office of Aging and Adult Services (OAAS)
- Bureau of Health Services Financing (BHSF)
- Department of Health and Hospitals (DHH)
- Office of Citizens with Developmental Disabilities (OCDD)
- Medicaid
- Home and Community Based Services (HCBS)
- Knowledge of medical and developmental disability terminology
- Social assessment and evaluation
- Task and project organization
- Word processing and relevant computer applications
- Customer relations and service
- Leadership and motivation
7
Referral Specialist Resume Examples & Samples
- 3+ years of business office or related experience
- Knowledge of third party requirements as they relate to referrals
- Demonstrated ability to work with computerized systems such as a PC, Point of Service device and online interfaced systems
- Organizational ability to manage workload while coordinating with multiple departments
8
Clinical Referral Specialist Resume Examples & Samples
- Evaluates the medical necessity and appropriateness of care, optimizing patient outcomes. Assesses patient admissions and continued stay, utilizing standard criteria
- Coordinates patient placement among multiple outreach and network facilities for admissions and transfers. Coordinates safe patient transfers according to established operational processes and guidelines in place for all service lines at each facility. Alerts staff at appropriate entity/agency of incoming/outgoing patients, scheduling bed/services, performs clinical and financial screening of referred patients and coordinates transportation. Serves as a liaison with other departments, leaders and presiding physicians regarding process improvement opportunities for patient flow, patient transfers and efficacy of communication process
- Manages individual patients across the healthcare continuum to achieve the optimal clinical, financial, operational and satisfaction outcomes. Serves as a liaison for the continuum of care including preadmission, hospitalization and community follow-up, depending on work assignment
- Maintains process for assessing current referral patterns for selected target areas by identifying physician referral patterns, health related community events, established physician practices and major gatekeepers in outreach and network communities. Establishes and promotes collaborative relationships with physicians, payers and other members of the healthcare team, including non-Banner entities (vendor management). Seeks opportunities to increase the growth of business within the assigned communities, identifying and cultivating potential referral sources relevant to the population served
- Collects and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. Provides outcome data with targeted audiences including physicians, medical case managers, rehabilitation professionals, insurance adjustors and industrial representatives
- Serves as a resource to other staff members and promotes a collegiality between staff physicians and leaders. Participates in interdisciplinary healthcare teams to facilitate the integration of managed care concepts within the daily practice standards. Acts as a consultant within the organization and in the community
- Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks and participating in professional societies
- May supervise staff depending on work assignment
9
Referral Specialist Resume Examples & Samples
- Schedules appointments for specialty physician services and diagnostic testing per provider request and communicates with the patient on a timely basis for all scheduling requirements
- Acts as a liaison between patients, providers and staff members for patients referral and follow up needs. Provides prompt and professional service for the patients by assisting in educating patient/family and assisting patients with external resources when needed
- Provides all pertinent clinical information needed for the payor authorization, the facility or specialist prior to the services being rendered by verifying coverage, obtaining authorization and communicating with receiving facilities
- Tracks and manages all referrals by monitoring outstanding referrals at 30/60/90 day intervals and following up with patients if appointments are not kept
- Applies knowledge of medical terminology and maintains up to date knowledge of insurance environment. Utilizes internal and external resources to seek knowledge about regulations regarding various payor sources
- Collaborates with outside referral sources and other community resources. Maintains an updated list of community resources and networks with colleagues to develop additional referral sources
10
Referral Specialist Resume Examples & Samples
- Must be able to work under time pressures in a busy clinic/call center environment
- Must be present on site for 8 hour shifts during standard clinic/access center hours
- Must be available to potentially work overtime if needed
- Must maintain attention to detail over extended period of time, and be continually aware of variations in changing situations
- Travel between clinic/access centers maybe required
- Must be able to move throughout the clinic/access center environment throughout duration of shift
11
Referral Specialist Resume Examples & Samples
- Six months of recent relevant experience
- Able to use a variety of electronic information processing tools and multiple software programs
- Professional, interactive written and verbal communication skills
- Able to multi-task without losing sight of accuracy & quality
- Able to establish priorities, work independently and proceed with objectives without direct supervision
- Able to thrive in a fast paced environment
- Able to work a full time (40 hours minimum) flexible work schedule to include some weekends
- Related experience in healthcare, customer service and/or call center
- Experience with outbound calls
12
Referral Specialist Team-frontline Leader Resume Examples & Samples
- Provide managerial oversight of Humana At Home Associates
- Monitor and audit staff performance
- Oversight of daily operations
- Ensure compliance and accuracy regarding program design and implementation thru monitoring and reporting of associates
- Meet or exceed business goals while providing perfect member experience
- Review current processes and provide modification as the business needs change and present the changes to the business leaders
- High school Diploma
- Previous formal leadership experience or 1-2 years of equivalent experience in coaching individual team members towards meeting and exceeding productivity goals
- Ability to effectively develop, mentor and train associates at all levels and drive increased performance
- Proven ability to work independently and demonstrate critical thinking skills
- Intermediate to advanced proficiency with Microsoft Excel for data analysis and reporting
- Ability to use a variety of electronic information processing tools and multiple software programs
- Demonstrated ability to handle multiple tasks in a fast-paced, changing environment
- 1-3 plus years of formal management/supervisor experience
13
Clinic Referral Specialist Resume Examples & Samples
- Communicate details information and answers patients’ questions regarding their health care plan; provide answers to billing and insurance clarifications questions
- Maintain direct address’ to send referrals electronically utilizing the system, as appropriate
- Perform other duties as assigned by the clinic director or physician
- Misc. office duties (i.e. copying, filing, retrieval of films/medical records)
- Mandatory Reporting Certificate (obtained within 45 days of start date)
14
Intake / Referral Specialist PRN Resume Examples & Samples
- Masters degree in Behavioral Health Related Field or current California RN license required
- Current Basic Cardiac Life Support required
- State of California License in either, Marriage and Family Counseling, Social work, or Clinical Psychology preferred
- Minimum of two (2) years experience in a behavioral health field
- Ability to learn and utilize computerized patient care management system
15
Infusion Referral Specialist Resume Examples & Samples
- Current knowledge of health insurance concepts and requirements (including HMO, PPO, Medicare, Medi-Cal, and other federal and state agency programs.)
- Knowledge of medical billing procedures, including CPT, ICD-9/ICD-10 and HCPCS codes, and medical terminology to accurately enter charge and copayment data into billing programs to support accurate billing or patients' various medical insurance carriers and ensure appropriate reimbursement in compliance with applicable regulations
- Knowledge of medical office scheduling procedures sufficient to create and manage efficient schedules for the Infusion Center(s)
- Knowledge of medical terminology sufficient to identify, interpret and explain medical procedures to patients, third party payors and medical facility personnel
- Able to sit at a computer terminal with telephone headphones for extended periods of time
- Ability to deal sensitively and effectively with very ill patients
- Strong writing skills to include the ability to compose, edit, and proof a wide variety of documents
- Excellent time management skills and the ability to manage frequent telephone patient contacts while effective maintaining and documenting data in the patient registration systems
- Ability to utilize multiple modes of communication (e.g. phone, fax, patient portal, e-mail, physician portal, mail, etc.) in a professional, accurate, efficient and courteous manner
- Demonstrated ability to work in multiple computer systems, such as patient registration/accounting systems, document imaging, scanning, payment posting, proprietary payer websites and data quality monitoring, both accurately and efficiently
- Excellent verbal and written communication and active listening skills Interpersonal skills necessary in dealing with internal and external customers
- Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Sutter Health
- Requires the ability to work with and maintain confidential information
- Typing speed and accuracy at 45 CWPM, allowing for the accurate computer entry of the needed volume of data, and to query accounts while patients are on the phone/ in person
- Ability to asses situations, prioritize workload, develop solutions and make recommendations
16
Referral Specialist Resume Examples & Samples
- Responsible for the prior authorization and referral process to ensure timely turnaround on orders for complementary and procedure services that are performed
- Provides information, coordinates Medical/Legal requests, and acts as a resource with regard to payers
- Safety liaison; Excellian patient management super user; backup support roles: Kronos processor; patient access reporting; supply ordering; front desk and medical secretary coverage; tech support for providers and clinic staff; patient care line voice mail recorded greetings; checking medical records phone for ill calls, calling for agency staff for replacements if needed; case management facilitation in social workers absence
17
Metcare Referral Specialist of Plantation Resume Examples & Samples
- Demonstrated ability to create an exceptional patient experience leveraging excellent customer service skills
- Strong organization and time management skills with the ability to prioritize and multi-task. Organizes and manages multiple priorities and/or projects using appropriate methodologies and tools
- Self-motivated and committed to achieving best results
- Experience with Electronic Medical Records
18
Referral Specialist Resume Examples & Samples
- Processes all requests for information following established legal guidelines
- Maintains database of information for area of responsibility
- Analyses data and compiles statistics
- Assists in the preparation of reports
- Answers, screens and transfers telephone calls
- Organizes and distributes correspondence, reports, memos, etc
- Performs additional duties as assigned
- Add Other Details Specific to this Coordinator Role
- Minimum: 1-3 years of experience
- Over 2-5 years of experience within specific job and/or department
- 10-key skills
- Demonstrated ability to take initiative, ask questions, and prioritize
- Capable of working independently as required
19
Recommend & Referral Specialist Resume Examples & Samples
- Medical, Dental, and Vision Plans
- Retirement Plan – 401k with matching
- Disability insurance
- Time away from work – vacations and holidays
- Professional development - SunTrust University, an in-house career growth and employee development program
- Tuition Assistance – financial help for going back to school
20
Assessment & Referral Specialist Resume Examples & Samples
- Completes age-appropriate psychiatric assessments of patients in the emergency department to include making recommendations to the requesting physician concerning behavioral health needs and arranges for transfer to another facility if needed. Provides referrals for those patients who are determined not to need hospitalization and notifies the appropriate persons or referral source of disposition
- Completes employee psychiatric assessments to determine risk to self or others when necessary
- Coordinates the delivery of telepsychiatric services to the requesting physician according to established guidelines. Assures clear proactive communication between physicians to support good clinical care to the patient
- For the patient needing inpatient treatment verifies insurance benefits, eligibility and obtains pre certification, arranges for an attending psychiatrist for the patient
- Completes required documentation, which includes but is not limited to the psychiatric assessment, timely, thoroughly, and legibly
- Education: ONE of the following
- Employee completes initial and ongoing training and competencies as defined by the service line, facility and department/unit which are specific to the needs of the patient population served (if applicable)
- Preferred: Three (3) years experience in mental health setting, Emergency Department or crisis management
21
Referral Specialist Resume Examples & Samples
- Handle phone/email questions from members about referral placements
- Responsible for determining needs analysis by contacting the customer to confirm information and clarify / obtain additional information to best service the customer
- Counsel customer to real estate needs to process along with pertinent real estate / lifestyle practices in area
- Follow action plan from analysis of member / customer needs to determine appropriate office and sales agent to best service the customer
- Negotiate referral fees
- During duration of active referral, act as a liaison between member / customer, sales office/ agent to ensure appropriate actions and process are being performed
- Data entry of file specifics and ongoing file management in several systems on a daily basis for file tracking-follow up along with input of completion of referral
- Track member and customer requests and directives to be tracked per file
- Responsible for assignment and follow up with assigned agent. Responsible for counseling on process and working with assigned agents with process, procedure and pertinent documents needed from placement to close
- Enter file in Relocation Database. Follow process in relocation database to track and close
- Create appropriate directives for finance to close out appropriately
- 1-3 years administrative experience/support center processing
- State Real Estate License required
- 1-2 years real estate or relocation experience as well as rental/internal experience preferred
- Strong organizational, prioritization, and time management skills
22
Referral Specialist Resume Examples & Samples
- Receives and documents, telephonic, and electronic requests for referrals from Primary Care Physicians, Specialists and Ancillary providers
- Contacts review organizations and insurance companies to obtain prior approval requirements and submit appropriate documentation
- Performs data entry/processing of referral requests through the EPIC system, and edits referral notes with appropriate information as outlined per department procedures
- Provides source of referral and prior approval requests with timely notification of approval or denial decisions through designated communication routes
- Provides input to Team Lead and Supervisor/Manager regarding improvements to operating practices
- Assists with orientation and training of new staff
- High School diploma required, College Education preferred
- Good judgment
- Resourcefulness in problem solving
- Able to take and follow through with delegated tasks and accountability
- Informational Ordering: The ability to arrange things or actions in a certain order or pattern according to a specific rule or set of rules (e.g., numbers, letters, words, etc.)
- Integrity/Ethics: Demonstrates personal integrity, honesty, sincerity. Trusted to do the right thing
- Results Oriented: Focuses self on value driven quality results through efficiency, critical thinking and solution oriented performance
- The preceding description represents the most significant duties of the job but does not preclude other occasional work assignments not mentioned within this document, the inclusion of which would be in conformity with the grade assigned
- Experience working with physicians and clinical staff in a medical or clinical setting – Medical Assistant preferred
23
lpn Referral Specialist Antelope Creek Clinic M F Resume Examples & Samples
- Set up appointments, coordinate clinic visits, and any special arrangements such as transportation, interpreter services, specialty care, etc
- Assist Practice Manager with complaint resolution and solutions related to patient referrals
- 0-1 years' experience in a medical clinic. Medical Assistance or LPN background
24
Referral Specialist Resume Examples & Samples
- Intermediate in Microsoft Office applications Word and Excel
- Healthcare or medical experience
- Familiarity with medical terminology and/or ICD-10 codes
25
Clinical Referral Specialist Resume Examples & Samples
- Previous experience in a similar position
- Marketing experience in a healthcare environment
- Familiarity with the acute hospital setting and inpatient rehabilitation setting
26
Referral Specialist Duke Consultation & Referral Center Resume Examples & Samples
- Serves as the first point of contact to Duke Health providing an authentic, consistent and accountable experience for our patients and referring providers
- Performs multiple intake responsibilities in support of Duke Health Marketing initiatives for clinical services, programs, providers and events, and also functions as the single point of entry for dukemedicine.org users, and other targeted audiences needing to speak to a Referral Specialist about a question, an issue, a physician, an appointment, etc
- Employs a systematic approach in problem solving to make decisions based on thoughtful analysis of the situation in evaluation of alternatives to perform multiple and complex responsibilities to schedule timely appointments for patients with Duke Health providers when the Duke Consultation & Referral Center (DCRC) serves as the direct scheduler
- Communicate opportunities to improve the patient/referring provider experience or scheduling process to their supervisor/manager
- Promote Duke MyChart
- Participate in all required meetings and teams as directed by their supervisor/manager
27
Patient Services Rep / Referral Specialist Resume Examples & Samples
- Responsible for receiving and resolving patient billing inquires and complaints in a professional manner
- Responsible for the referral process to ensure timely turnaround on orders for complementary and procedure services that are performed
- Field patient phone calls: pricing quotes, information about pain program, insurance coverage questions (from existing and potential new patients), calls from QRC’s, claims adjusters, etc
- Manage the communication and the entire handoff and care coordination process, including scheduling the patient for the appointment, completing the Excellian documentation, coordinating records, and if needed health plan requirements
28
Referral Specialist Resume Examples & Samples
- Maintains knowledge and skills of front office operations in order to assist as necessary with reception, medical records, scheduling, and billing functions
- Maintains a good rapport and cooperative working relationship with all members of the medical office, other medical offices, hospital services, and community agencies
- Maintains technological competencies, organization, and neatness in the work area. Completes all mandatory in-services in required timeframe. Regularly assists co-workers as needed. Utilizes resources in a manner, which reflects an understanding of proper stewardship
- Receives and screens all incoming calls for distribution to the nurse reviewer or appropriate department. Verifies eligibility and status of referrals when appropriate for the physician office and/or member. Maintains quality customer service at all times with callers exhibiting courteous and professional behavior
- Demonstrates behaviors consistent with identified competencies and job requirements (i.e., continuing education, mandatory in-services, safety training, annual TB testing and organizational integrity program)
- Notifies appropriate personnel of equipment malfunctions and needed repairs
- Acts as liaison between provider offices, physicians, health plans and other departments to ensure high quality customer service are being delivered
- Possess an ability to deal effectively in high stress situations, to evaluate current processes for enhancement, and make necessary recommendations
- Maintains a working knowledge of each product including, but not limited to, employer groups, benefit plans, benefit limitations and additions
- Accepts assignments of additional duties when indicated to maintain department operations
29
Referral Specialist Resume Examples & Samples
- Bachelor’s Degree (BA) in healthcare associated field. Equivalent years of experience may be substituted
- 3+ years experience working in the medical field
- Experience interacting with and engaging customers virtually over the phone
- Highly developed service and exceptional communication skills, including a personable, professional presence over the phone
- Demonstrated proficiency of computer skills and use of clinical and office software applications, including a phone queue system
- Ability to manage multiple priorities and tasks in a fast-paced environment
- Ability to learn new processes, a complex delivery system, and technology quickly, and aptitude for continuous change and department growth
- Ability to develop and maintain strong, positive working relationships with team members, leaders, clinic staff, and other partners
- 5+ years customer service preferred
- Knowledge of Cruise line industry and related occupational medicine is desired
- Knowledge of worker’s compensation laws, procedures, and regulations is desired
- Certification in a health care related field preferred
30
Information / Referral Specialist Resume Examples & Samples
- 3 years of experience in an administrative and/or progressively responsible secretarial position
- In Compliance with the Department of Human Services (DHS), criminal background check is required for this position, based on assigned duties, Fingerprinting may also be required
- Experience with triaging information and referral calls
31
Referral Specialist Resume Examples & Samples
- Bachelors Degree in relevant field
- Proficient in a Windows environment including Word, Excel and Microsoft Outlook
- Proven and demonstrable track record success in sales, marketing and public relations activities in the health care and/or human services sector
32
Ins Auth / Referral Specialist Resume Examples & Samples
- Knowledge of ICD/CPT
- Knowledge and understanding of financial and medical insurance information; collections experience
- Two years of medical office, authorization or hospital environment experience OR a combination of experience and education in a medical course of study from an accredited institution
- Basic computer literacy and proficiency in Microsoft Windows, including experience using multiple software/computer applications simultaneously
- Ability to effectively capture information and accurately enter the data into software applications
- Excellent interpersonal skills and the ability to effectively communicate verbally and in writing providing excellent customer service
- Knowledge of the principles and processes for providing effective customer service, including customer needs assessment, meeting quality standards for delivered services and evaluation of customer satisfaction
- Excellent organizational skills with the ability to multitask and handle multiple priorities/tasks simultaneously in a fast paced environment
33
Healthcall Referral Specialist Resume Examples & Samples
- Provides physician referrals to consumers, and serves as a liaison to physician office staff to facilitate scheduling of patient appointments. Monitors physician's office ability to accept new patients
- Provides class scheduling and information related correspondence to both the general public and physician office staff
- Minimum of three years' experience in a business office environment of a healthcare organization. Experience in telemarketing and healthcare telemarketing
34
Referral Specialist Resume Examples & Samples
- Initiates and manages clinical referrals for pre-authorization
- Acts as a liaison between hospital, health plans, physicians, patients, vendors and other referral sources. Reviews referrals for completeness and follows up for additional information if necessary
- Assigns referrals to staff as appropriate
- Verifies insurance coverage and obtains authorizations if needed from insurance plans
- Maintains database of insurance companies including numbers for verification of coverage, accepted plans, and requirements for patient eligibility
- Contacts physician offices as needed to obtain demographic information or related data
- Access to more than 3,000 online training courses through our Kelly Learning Center
- Group-rate insurance options available immediately upon hire*
- Available for purchase and administered by a designated third-party vendor
- Important information: This position is recruited for by a remote Kelly office, not your local Kelly branch. Please submit your resume to be considered for this position by pressing the “SUBMIT RESUME” button below. Please email Courtney Keller at kelleco@kellyservices.com for any additional questions about the job posting
35
Referral Specialist Resume Examples & Samples
- Contacts insurance carriers after verifying information to secure benefit coverage, policy limitations, pre-certification, etc. for customers
- Conducts follow-up calls as necessary to physician offices, patients, and third party payers to complete pre-certification process
- Contacts relevant internal staff to update status, coordinate resolution/correction of issues, sends records to insurance companies and determines whether a denied authorization should be appealed
- Educates internal and external customers regarding referral/prior authorization requirements, eligibility guidelines, documentation requirements, and insurance procedures
- Basic computer skills required Obtain Nationally recognized Medical Assistant Certification or Registration within 90 days of hire
- Must be able to work as a member of a team along with effective communication skills
36
Referral Specialist Resume Examples & Samples
- Works with leadership to establish and maintain effective policies and procedures for managed care referrals, revenue cycle, and co-payment collection for the department. Ensures that all required managed care referrals for patient visits have been obtained or that a waiver is signed
- Serves as primary resource on all departmental managed care matters; develops, implements and monitors departmental referral management processes, resource tools, and report findings on a regular basis
- Represents the practice on hospital based Referral and Registration Operations committees. Acts as liaison between the practice and the managed care office and committees. Works closely with the physicians organization and the managed care office to communicate managed care principles and policies to the practice
- Educates and trains administrative assistants and practice assistants in the area of Referral Management and Pre-Registration. Participates in administrative staff meetings reporting statistical referral management and pre-registration measurements and indicators, and communicating referral management information
- Acts as a managed care resource on the unit to social workers, pharmacists, physicians, nurses and resource specialists for issues regarding managed care and insurance coverage, including commercial payers, Medicare, and radiology pre-certifications
- 3-5 years related work experience required
- Two years of experience in referral management or insurance managed care environment
- Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access
- Knowledge:Ability to demonstrate full working knowledge of standard concepts, practices, procedures and policies with the ability to use them in varied situations
- Team Work:Ability to act as a team leader for small projects or work groups, creating a collaborative and respectful team environment and improving workflows. Results may impact the operations of one or more departments
37
Referral Specialist Resume Examples & Samples
- Online continuing education via the Kelly Learning Center
- Several employee discounts
- Enters referrals, documents communications, actions and other data in system. EDUCATION/EXPERIENCE
- Requires high school diploma and 1-3 years experience in healthcare environment preferred or any combination of education and experience, which would provide an equivalent background
- Excellent customer-service and telephone skills required. Excellent oral and written communications skills required
38
Physician Authorization / Referral Specialist Resume Examples & Samples
- Ensure timely notifications and requests for authorizations/referrals are handled in accordance with departmental policy and payor requirements
- Maintain confidentiality and verify patient demographics, insurance eligibility, benefits and financial responsibility
- Ability to request/obtain authorizations/referrals for assigned specialties and ability to cover for most specialties
- Communicate in an effective, timely and professional manner in writing and verbally
- Contact and interview families in person or by phone contact to obtain necessary information and assist them with insurance issues that may be preventing authorizations/referrals
- Clearly document all communications and contacts with payors and families in standardized documentation requirements, including proper format
- Consistently demonstrate excellent, empathetic and knowledgeable customer service skills to internal and external customers
- Is aware of and adheres to all state and federal regulations including, but not limited to, EMTALA, HIPAA and the Joint Commission
- Ability to review workflows and suggest improvements in specialty areas
- Ability to work independently, prioritize workload and assist other associates as required
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Prior Authorization / Referral Specialist Resume Examples & Samples
- Secures all required prior authorizations for EMG's, EEG's, Stress Tests, Stress Echo's and Echo's and other outpatient clinical testing
- Secures all referrals for outpatient clinic visits as needed
- When required, contacts the ordering provider for more detailed clinical information to support the required procedure
- Communicates effectively with ordering provider offices on prior authorization status for all appointments requiring a prior authorization or referral
- Maintains consistent documentation, as well as written handoffs to appropriate individuals when planning time off, so that other team members can assist in securing authorizations and/or referrals as needed
- 0-1 years related work experience required in healthcare related position, with specific experience in obtaining Prior Authorizations and Referrals
- Independence of Action:Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager
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Clerical Referral Specialist Resume Examples & Samples
- Minimum of two years experience working in a health care environment required
- Customer service background via telephonic communications required
- Proven customer relations and phone etiquette abilities required
- Clerical and computer skills required including experience with office machines and a working knowledge of phone and filing systems
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Referral Specialist Resume Examples & Samples
- Facilitates relationships with referring physicians. Identifies any issues regarding referring physicians' access to the organization's facilities and works to promote resolution
- Promotes the organization's medical specialists and/or services to referring physicians within the applicable service area for enhanced relationship development
- Educates referring physicians regarding new and existing organizational initiatives
- Facilitates continuing medical education opportunities for referring physicians
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Referral Specialist Resume Examples & Samples
- Obtain required authorizations from insurance companies
- Inventory and order clinic supplies and medications
- Assist receptionist and medical records clerk as needed
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Referral Specialist Resume Examples & Samples
- Two years medical office experience required
- Is the initial contact of each new patient
- Completes registration and obtains insurance authorization for new patients and for hospital admissions
- Ensures financial information/copy of insurance card is forwarded to billing
- Obtains pertinent medical records before establishing an appointment for new patients
- Works closely with nursing and medical staff to facilitate optimal patient care
- Schedules physician appointments for new patients
- Coordinates with other departments as needed to facilitate patient’s visit
- Provides each new patient with the appropriate administrative guide
- Provides patient with referral information for other physicians/facilities
- Able to maintain reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards
- Able to maintain compliance with all Orlando Health policies and procedures
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CEA Referral Specialist Resume Examples & Samples
- Bachelors Degree in Social Work or related field and/or equivalent education and experience
- At least one year of experience in direct provision of social services, preferably working with people experiencing homelessness. Knowledge of housing programs in King County
- Ability to answer phones and provide consistent and timely information to our diverse population
- Understanding of issues faced by people experiencing homelessness, including chemical dependency, mental illness, domestic violence, and long-term homelessness
- Demonstrated understanding of trauma-informed care
- Strong organizational skills and attention to detail. Ability to update and maintain complex client records
- Proficiency in 2010 Microsoft Office Suite
- PREFERRED QUALIFICATIONS
- Master's degree in social services or a related field
- Demonstrated knowledge of and experience in working with people experiencing homelessness or homeless services
- Second language proficiency
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Referral Specialist Resume Examples & Samples
- Outgoing Referral experience preferred
- Prior-Auth and ICD-10 experience preferred
- Ambulatory experience preferred with Medical Terminology
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Physician Referral Specialist Resume Examples & Samples
- 4 years experience in appointment scheduling, customer service or related field
- Must have computer skills and dexterity required for data entry and retrieval of patient information
- Must be proficient with Windows-style applications and keyboard
- Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process
- Additional degrees, business training experience and/or certifications may be combined to meet minimum qualifications
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Pathology Referral Specialist Resume Examples & Samples
- Correctly receives, accessions, processes, and assures proper identification of specimen
- Evaluates specimen integrity and notifies appropriate personnel of unacceptable specimens in accordance with departmental procedure
- Perform a thorough review of all associated paperwork (i.e. outside pathology report, outside billing information, commercial laboratory requisition, research request, etc.)
- Compare materials/documents received against information in HIS, initiating communication with PAS to resolve discrepancies or to initiate financial clearance
- Determine additional materials, information or reports needed for processing and initiate action to request/obtain
- Acquires and maintains proficiency in computer functions
- Keeps abreast of new procedures and policies
- Maintains neat, accurate and complete records according to established policies and procedures
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Referral Specialist / St John Clinic Resume Examples & Samples
- Notifies case management about interactions with insurance companies regarding services. Manages denials or potential denials as described by insurer
- Monitors and reviews applicable schedule to ensure that authorization and initial length of stay is obtained and on file
- Medical Assistant experience preferred. 1 year working experience in the medical field required. Knowledge of medical terminology preferred
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Referral Specialist Resume Examples & Samples
- Assist patient with finding resources that accept various insurances, when processing Outgoing/External referrals
- Determines patient's financial responsibilities as indicated by insurance carrier
- Configures coordination of benefit information and eligibility on every referral
- Collects any clinical information such as lab values, encounters, and diagnosis codes as needed
- Documents all pertinent communication with patient, physician, and insurance company as it will be a viable source in support of requested services
- Reviews and manages Epic Work queues and other information pathways to maintain accurate authorization requests
- Schedules appointments as appropriate within required timeframes
- Serves as a resource liaison with referral / appointment inquiries from patients, clinical care teams, and other staff
- Meets productivity and documentation standards while following planned priorities as set by Team Supervisor
- Maintains patient privacy as indicated by Network Policy
- Performs other related job duties as assigned
- 1 plus years of progressive responsibilities and direct work related experience
- Associate Degree in a related field of study from an accredited college or university
- 3 plus years of progressive responsibilities and direct work related experience
- Medical Coding and Hospital Billing reimbursement experience
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Pathology Referral Specialist Resume Examples & Samples
- Adjusts, prioritizes, and organizes work to achieve maximum productivity to meet the workload demands of the section
- Assists peers and supervisors with tasks after completion of assigned work
- Adheres to attendance policy, begins work as scheduled
- Works independently, utilizes resources available to maximize efficiency
- Actively participates in training students, employees and fellows
- Participates in process improvement projects
- Validates and evaluates new methodologies and tests with the help of Laboratory Supervisor and technical support
- Validates database for new software or new tests implemented in the laboratory
- Coaches and mentors students and employees
- Maintains proficiency on computer functions in the lab processes
- Properly acquires specimen data into computer system(s)
- Analyzes and evaluates patient results correctly and appropriately
- Stores patient information and results to allow easy future access as required
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Referral Specialist Resume Examples & Samples
- Applies principles of specific managed care product to each task to insure contractual compliance
- Insures timely flow of information regarding managed care contacts and/or patients to specialist, primary care physicians, staff and patients
- Keeps current with managed care products and how changes may affect
- Pre-certifies patient services and obtains necessary approval of specialties, hospital admissions, emergency treatment, out of office testing, rehabilitation, DME, and any other necessary service
- Understands roster management and is able to assist with it as assigned
- Works with manager to maintain files, coordinates patient care as it relates to quality assurance and utilization review
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Referral Specialist Resume Examples & Samples
- Obtains authorization on for admissions as required by health plans
- Enters patient insurance authorizations and any pertinent information from insurance company into the patient account history. Documents insurance coverage of services to be provided
- Responsibilities may vary over time. Required to perform other duties as required for the efficiency and effectiveness of the department and job role
- Medical Assistant experience preferred
- 1 year working experience in the medical field required
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Resource / Referral Specialist Resume Examples & Samples
- Knowledgeable about child health, child development and available community resources
- Ability to work with multidisciplinary team; demonstrated effective verbal and written communication skills
- Ability to effectively speak in public, cooperate and relate well with individuals from all socioeconomic backgrounds
- Ability to work effectively with employees from other agencies and members of community groups
- Provides hands on assistance and support to childcare providers
- Provides training to childcare providers, families and the community
- Maintains documentation according to established protocol and organizational standards
- Develops and maintains professional and community relationships
- Maintains and continues professional development
- Performs other job functions as requested or assigned
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Referral Specialist / Ummc Fayette Clinic Resume Examples & Samples
- Obtain clinical and demographic information of potential patients through telephone triage
- Schedules and facilitates potential patients through the screening process
- Networks with Division staff regarding new referrals
- Answers and screens telephone calls for appropriate services and programs within the Division
- Collects and performs completion of compliance statistics and other admission requirements
- Assists in promoting Community Psychiatry to outside referral sources by telephone communication
- Professionally represents the UMMS Division of Community Psychiatry as the point of contact for potential consumers and referral sources
- Assist with data of entry of various program questionnaires and Health Home statisics
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Assessment / Referral Specialist Resume Examples & Samples
- Completes the comprehensive admission process in accordance with LOBHC policies and procedures
- Records observations accurately and concisely and maintains patient's medical record in accordance with LOBHC standards
- Demonstrates effective oral and written communication skills
- Receives referral calls and relays information for follow up in a timely manner
- Informs callers of programs available at Laurel Oaks Behavioral Health Center
- Provides crisis intervention
- Obtains sufficient information for verification of insurance benefits
- Arranges for financial counseling if needed
- Collects data to utilize in the assessment process
- Communicates with appropriate physician and follows recommendations for disposition
- Participates in weekly on call rotation schedule
- Master's Degree in Counseling, Psychology, Social Work or related field required
- Two years counseling experience preferably in a general psychiatric setting (outpatient or inpatient) and crisis intervention
