Referral Center Specialist

Overview

First Health of the Carolinas is a nationally recognized health care system located in central North Carolina. Comprised of four hospitals with more than 600 beds, the system also offers leading-edge heart care in the Reid Heart Center, the area’s only dedicated heart and vascular center. Our growing health system has more than 6,200 employees serving in more than 75 locations throughout a 15-county service area.

In addition, First Health has received numerous accolades for its patient care and outcomes, including recognitions from Health grades, U.S. News & World Report, and Becker's Healthcare.

Must be capable of cross training and adapting to electronic medical records in a clinic setting showing progressive efficiently with this method of technology. Answers phones, routes calls and or takes accurate message. Adapts to a phone menu if one is in use. Demonstrates a sense of urgency relating to patient's level of distress.

Schedules patient appointments with specialty providers including the correct processing of necessary referral forms and transfer of patient information. Reviews insurance to obtain authorizations for diagnostic testing, office visits, procedures, etc. Reviews clinical data to provide insurance company with information needed for authorization. Effectively communicates with the clinical team when an authorization is denied. Maintains referral record in Epic. Ensures referral data fields are completed.

Opens and distributes incoming mail to appropriate parties. Meeting attendance as required.

High school graduate. 1-2 years of medical insurance experience or experience obtaining authorizations and referrals and medical office experience preferred.

Experience with EMR systems; office automation skills; extensive knowledge of CPT and ICD-10 coding and authorizations; strong interpersonal and verbal communication skills; good organizational skills. Is committed to and demonstrates excellent customer service when dealing with all types of customers.