Referral Processing Specialist
Core
Process home health referrals from various sources, verify patient demographics and insurance coverage, and coordinate care transitions for patients discharging home.
Role type
Referral Processing Specialist
Builds
Home health care service access and continuity for patients
Domain
Healthcare / Home Health
Deliverable
client delivery
Required skills
Medical terminology, Medicare/Medicaid and third-party payer guidelines, telephony and electronic systems, data entry in EMR, insurance eligibility verification, report monitoring
Preferred skills
Call center experience, knowledge of health care industry, Microsoft Office proficiency
Technologies
Electronic Medical Records (EMR), Microsoft Office (Word, Excel), telephony systems
Responsibilities
Triaging home health referrals received via phone, email, or fax; verifying patient demographics and insurance coverage; assembling referral data in EMR; troubleshooting calls and routing concerns; coordinating transfer of care documentation; maintaining communication with referral sources and clinical staff; monitoring pending patient reports.
Seniority
Entry-level to Mid-level, hands-on operational role