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Job description
Referral And Insurance SpecialistThank you for considering a career at Roper St. Francis Healthcare!Scheduled Weekly Hours:40Work Shift:Days/Afternoons (United States of America)Work Shift: Monday - Thursday, 7:30am - 4:30pm and Fridays, 7:30am - 2:00pmWork Locations: First 6-months, travel to all locations. After training, will work from one location 2-days/week and rotate to other locations 3-days/week for clinic days. All locations are BSSF MOB (West Ashley), Mount Pleasant MOB, and Moncks Corner MOBRequired Experience: 1year+ of medical referral and insurance verifications is required.Primary Function/General Purpose of PositionThe Referral and Insurance Specialist obtains authorizations from insurance companies for referrals to physicians and/or procedures/testing. Verifies eligibility/coverage for referral via phone/fax/Internet. Schedule appointments for testing at medical facilities or appointments with physicians. Gathers charge information and enter all pertinent charge and patient demographic information into computer billing system. Post all payments and make daily deposits. Assist patients regarding billing questions and account balance resolution. Promotes a positive and helpful climate for good interpersonal and interdepartmental relationships.Essential Job FunctionsObtains authorizations from insurance companies for referrals to physicians/medical facilities and/or procedures/testing.Schedules appointments for testing at medical facilities or appointments with physicians.Verifies eligibility/coverage for referral/testing via phone/fax/Internet.Investigates billing problems and denials.Notifies patients of referral process whether authorized or denied in a timely manner. Give patients instructions.Performs data input of patient and/or insurance changes and corrections to ensure current and accurate information in billing system.Answers the telephone, take messages, schedule appointments and greet patients as needed.Prepares patient charge encounter forms for each day and makes new or updates patient chart as needed.Oversees waiting area, coordinate patient movement, and reports problems or irregularities.Screens visitors and respond to routine request for information.Organizes and files progress notes, testing reports, and other forms necessary for chart completion. Assists with appropriate filing of patient charts as needed.Collects patient responsibility balances and copayments as needed. Balance money collected daily.Opens and distributes daily mail as neededObtains authorizations from insurance carriers or pharmacy benefit managers for medications.Collects all daily charge slips from the physician and reconciles the number of charge slips and their totalsApplies all payments to the appropriate patient account by posting each into the computer billing systemsInputs all charge information into the online billing systemAssists with coding and error resolution as well as requesting needed information by working with the physician officesWorks with patients in resolving billing questions and patient account resolutionAs applicable, reviews information to make determination on the appropriate course of action for the patient, makes referrals to the local DSS office as appropriate.This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.Licensing/CertificationNoneEducationHigh School Diploma or GED (required)Work Experience2-3 years of experience in a related medical field with experience in processing referrals (preferred)TrainingNoneLanguageNonePatient PopulationDemonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit.Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures.Neonates (0-4 weeks)Infant (1-12 months)Pediatrics (1-12 years)Adolescents (13-17 years)Adults (18-64 years)Geriatrics (65 years and older)Not applicable to this positionWorking ConditionsPeriods of high stress and fluctuating workloads may occur.Long-distance or air travel as needed- not to exceed 10% travel.General office environment.May be exposed to high noise levels and bright lights.May be exposed to physical altercations and verbal abuse.May be exposed to limited hazardous substances or body fluids.*May be required to use physical restraints.May be exposed to human blood and other potentially infectious materials.*May be exposed to adverse weather conditions; cold, hot, dust, wind, etc.May have periods of constant interruptions.Required to car travel to off-site locations, occasionally in adverse weather conditions.Prolonged periods of working alone.* Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.Physical RequirementsPhysical DemandsFrequency 0% 1-33% 34-66% 67-100%Lifting/ Carrying (0-50 lbs.) XLifting/ Carrying (50-100 lbs.) XPush/ Pull (0-50 lbs.)Push/ Pull (50-100 lbs.)Stoop, Kneel XCrawling XClimbing XBalance XBending XWork PositionFrequency 0% 1-33% 34-66% 67-100%Sitting XWalking XStanding XAdditional Physical Requirements/HazardsPhysical RequirementsManual dexterity (eye/hand coordination)Perform shift workManeuver weight of patientsx Hear alarms/telephone/audio recordingsReach above shoulderx Repetitive arm/hand movementsx Finger DexterityColor VisionAcuity – farAcuity – nearNot applicable to this positionHazardsDepth perceptionUse of Latex productsExposure to toxic/caustic/chemicals/detergentsExposure to moving mechanical partsExposure to dust/fumesExposure to potential electrical shockExposure to x ray/electromagnetic energyExposure to high pitched noisesGaseous risk exposureOther:Not applicable to this positionSkillsAttention to detailOrganizedAbility to multi-taskExcellent customer serviceActive ListeningVerbal CommunicationWritten CommunicationProcess RequestsTelephone etiquetteComputer proficiencyRoper St. Francis Healthcare is an equal opportunity employer.As a Roper St. Francis Healthcare teammate, you're part of a Mission that matters. We support your well-being – personally and professionally. Our benefits are built to grow with you
Worksite address
mount pleasant, SC, 29464, US
Who can apply
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