Facility: Wellstar MCG Health

Job Summary:

The Referral Specialist is responsible for handling the referral process for specialized procedures in the ambulatory setting, ensuring that appropriate authorizations are requested, received and recorded in tapestry. Acts as the primary source for staff regarding authorizations, insurance plans, and specific procedural codes. The job duties include tracking of the patients and ensuring follow through. This is a clerical position working in a clinic with multiple providers and support staff.  Work situations require a poised individual, courteous manner, discretion, organization skills, and good judgment. Knowledge of all department functions and various insurance plan provisions is essential. This position requires extensive interaction with external customers to include other physician offices, insurance plans, and patients. Internal contacts include the nursing staff, providers, and centralized call center staff.

Core Responsibilities and Essential Functions:

• Researches patient eligibility and benefits; corresponding with patient accounts and faxing requested documentation.

• Contributes to the success of the organization by meeting organizational competency expectations and core values (respect, integrity, stewardship, excellence, collaboration and kindness), continuously learning, and by performing other duties as needed or assigned.

Required Minimum Education: High School Diploma

Required Minimum Experience: Two years of clerical experience.

Medical office experience and/or experience with CPT and ICD-9 coding preferred.

Required Minimum Skills:

Knowledge of and skill in the use of personal computer and related software.

Knowledge of medical terminology and medical ethics.

Time management, good grammar and spelling, good interpersonal skills.

Ability to deal with difficult people or situations in a professional manner.

Ability to train staff of all levels. Ability to work efficiently under pressure, with a high degree of accuracy.

Ability to work independently and take initiative.

Ability to exercise discretion and maintain confidentiality.