Referral Services Assistant

• Initiate and manage clinical referrals for participants registered in disease-management or health programs
• Provide administrative support to clinical teams for referrals involving case management, disease management, home health, nutritional counseling, and related services
• Act as a liaison between hospitals, health plans, physicians, patients, vendors, and other referral sources
• Review referrals for completeness and follow up to obtain additional information
• Assign referrals to staff
• Verify insurance coverage and obtain authorizations from insurance plans
• Maintain an insurance-company database covering verification of coverage, accepted plans, and patient-eligibility requirements
• Contact physician offices to obtain demographic information and related data
• Enter referrals and document communications in the system
• Handle calls, texts, facsimiles, and electronic queues while taking notes and speaking with customers
• Perform other duties as assigned

• HS diploma or equivalent
• Minimum of 1 year of experience in a healthcare environment
• Any combination of education and experience which would provide an equivalent background
• Ability to multitask while handling calls, texts, facsimiles, and electronic queues, taking notes, and speaking to customers simultaneously
• Ability to maintain focus during extended periods of sitting and handle multiple tasks in a fast-paced, high-pressure environment
• Strong verbal and written communication skills for virtual and in-person interactions
• Attention to detail, critical-thinking, and problem-solving abilities
• Empathy and persistence in resolving caller issues completely
• Comfort and proficiency with digital tools and platforms
• Ability to work a structured schedule with occasional overtime or flexibility based on business needs
• Ability to work from the office as necessary
• Ability to travel to the worksite and other locations as necessary
• Customer service experience strongly preferred
• New candidates in certain patient/member-facing roles must become vaccinated against COVID-19 and Influenza, unless an acceptable explanation is provided

Demonstrates strong administrative support capabilities in managing clinical referrals and case management within a healthcare environment, emphasizing attention to detail, effective communication, and customer service skills.

• Clinical Referrals Management
• Insurance Verification
• Customer Service Experience
• Strong Verbal And Written Communication
• Multitasking In High-Pressure Environments

• Case Management
• Disease Management
• Nutritional Counseling
• Data Entry
• Referral Documentation

• Attention To Detail
• Critical Thinking
• Problem Solving
• Empathy
• Persistence

• Healthcare Environment
• Patient Eligibility Requirements
• Insurance Plans
• Referral Sources
• COVID-19 Vaccination

• Digital Tools
• Electronic Queues
• Communication Platforms