Job Title: Referrals Clerk
Reports To: Medical Records and Referrals Supervisor
Job Summary: Processes and follows up referrals and some diagnostics, supplies clerical support to providers and support staff.
Essential Job Duties and Responsibilities:
The job duties and responsibilities listed below are representative of the knowledge, skill, and/or ability required. Other duties that fall within the broad scope of this classification may be assigned.
- Obtains Referral notes from specialists as required.
- Acquires and documents referral information from physicians, patients, and insurance carriers.
- Review’s referral paperwork to ensure that referrals are appropriate for the insurance carriers.
- Ensures that prior authorizations are completed for referrals as required by the insurance carriers.
- Follows-up to ensure that all required documents have been received by insurance carrier and referral is processed.
- Processes diagnostics orders according to policies and procedures.
- Runs reports according to policies and procedures to follow up on open referrals and diagnostics until closing the loop, electronically filing and documenting steps in the process.
- Working assigned weekends is required.
Minimum Qualifications - Education, Experience, Certificates & Licenses:
- High School Diploma or GED.
- Any combination of experience and/or education that provides the necessary skills required may be considered.
- Valid Fingerprint Clearance Card may be required.
- Experience in medical records or referrals preferred.
Required Language Skills:
- Ability to comprehend and compose instructions, correspondence, and communications in English in both oral and written format.
- Ability to occasionally exert enough force to move objects weighing up to 10 pounds.
- Ability to continuously remain in a stationary position.
- Ability to occasionally move about inside the workplace to access files, office machinery, etc.
- Possesses hand-eye coordination and manual dexterity necessary to constantly operate computer, telephone, and other office machinery.
- Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
- Ability to discern the nature of sounds at a normal spoken volume.
Other Required Knowledge, Skills, and Abilities:
- Ability to add, subtract, multiply and divide, using whole numbers, common fractions, and decimals.
- Ability to gather data in an organized fashion from varied sources.
- Ability to take direction and perform assignments accordingly.
- Knowledge of all aspects of insurance referral process.
- Computer literacy required.
- Understands covered services and contracted physicians enrolled with various insurance carriers.
- Ability to provide excellent customer service by mail, telephone, and in-person.
Work Environment & Conditions:
- Work environment is typical of an administrative office setting with no substantial exposure to adverse environmental conditions.
Will be responsible for Behavioral Health/Dental referrals