Referral & Insurance Specialist - Orthopedic Admin

Referral & Insurance Specialist - Orthopedic Admin

Join to apply for the Referral & Insurance Specialist - Orthopedic Admin role at Bon Secours.

With a legacy that spans over 150 years, Bon Secours is a network dedicated to providing excellent care through exceptional people. At every level, everyone on our teams has embraced the call to provide compassionate care. Here, you can work with others who share common values, and use your skills to help extend care to all of our communities.

As a faith-based and patient-focused organization, Bon Secours exists to enhance the health and well‑being of all people in mind, body and spirit through exceptional patient care. Success in this goal requires a culture of compassion, collaboration, excellence and respect. Bon Secours seeks people who are committed to our values of compassion, human dignity, integrity, service and stewardship to create an environment where associates want to work and help communities thrive.

The Referral and Insurance Specialist obtains authorizations from insurance companies for referrals to physicians and/or procedures testing. The Specialist verifies eligibility/coverage for referral via phone/fax/Internet, schedules appointments for testing at medical facilities or appointments with physicians, gathers charge information, enters all pertinent charge and patient demographic information into the computer billing system, posts all payments and makes daily deposits, assists patients regarding billing questions and account balance resolution, and promotes a positive and helpful climate for good interpersonal and interdepartmental relationships.

Candidates must live in the greater Cincinnati area as occasional on‑site meetings are required.

• Obtains 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. Gives 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, takes messages, schedules appointments and greets patients as needed.
• Prepares patient charge encounter forms for each day and makes new or updates patient chart as needed.
• Oversees waiting area, coordinates patient movement, and reports problems or irregularities.
• Screens visitors and responds to routine requests 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. Balances money collected daily.
• Opens and distributes daily mail as needed.
• Obtains 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 totals.
• Applies all payments to the appropriate patient account by posting each into the computer billing system.
• Inputs all charge information into the online billing system.
• Assists with coding and error resolution as well as requesting needed information by working with the physician offices.
• Works with patients in resolving billing questions and patient account resolution.
• As 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.

Education: High School Diploma or GED (required)

Licensure / Certification: None

2–3 years of experience in a related medical…