Insurance Referral Specialist (Central Referral Team - York)

Pinnacle Health Systems Harrisburg, PA
Job Details

Job Summary: Responsible for coordination of the referral process within PHMG. Responsible for coordinating specialty referrals and diagnostic testing for the PHMG sites. Pre-certifies diagnostic testing, as required by patient's insurance. Educates the patients on various policies, procedures, and benefits, related to the need for referrals. Coordinates referrals with patients and specialist's offices, and process insurance referrals as required. Acts as a liaison between patient, physician and insurance company, consistently performing activities in a friendly, courteous and professional manner.

Job Requirements: High school graduate. Medical Secretary or Receptionist with 2-3 years' experience in a physician's office or out-patient facility. Knowledge of Electronic Medical Records/Electronic Health Information systems. Knowledge of medical terminology, CPT and ICD-10 coding. Knowledge of insurance companies, guidelines and requirements, authorization and referral process and websites. Familiar with Windows software, Word and Excel and Outlook. Accuracy and attention to detail are extremely important. Must possess strong organization and communication skills and be able to work independently and within a team.

Preferred Qualifications: Experience in a primary care or specialty office is preferred.