Job Summary:

The Referral Specialist is responsible for processing referral requests following CareSouth Carolina guidelines and for providing courteous and professional assistance to patients and their families.

Duties/Responsibilities:

• Ensures that referrals are accurate and completed and scheduled in a timely manner
• Ensuring that provider’s diagnostic referral orders are prioritized and authorization competed as needed patient made aware of appointment
• Utilizes the visualutions/referral tracking system to track referrals. Appointments and authorizations are scheduled in a timely manner and task sent to Centralized Medical Records for tracking
• Utilizes established documentation system to notify the referring provider if patients do not adhere to the recommended plan of care and/or authorization is not approved
• Meets with Referral Technical Advisor individually and/or as a team routinely to review referrals and updated training on referral system. Also to provide timely solutions for all identified access/service problems and patient complaints

Required Skills/Abilities:

• Knowledge of insurance industry and health care plans including basic medical terminology/abbreviations
• Knowledge of information techniques and individual behavior activities
• Ability to demonstrate effective customer service techniques
• Ability to learn and apply policies and procedures applicable to the assigned work, including applicable regulatory requirements
• Ability to read/write sufficiently, proof and edit routine office correspondence, reports and forms including proper use of English grammar, spelling, and punctuation
• Ability to read, understand and follow oral and written instructions
• Ability to apply existing procedures to similar and make appropriate choices from established guidelines/procedures
• Ability to express ideas and convey information effectively in verbal and written communication
• Ability to understand and utilize numerical, alphabetical and automated filing systems; and the ability to perform basic arithmetic calculations (addition, subtraction, multiplication, division)
• Ability to establish and maintain effective working relationships with patients, staff, and the public (team player at all time) by communicating effectively, following instructions, and properly recording patient data
• Ability to act independently and know when to refer situations to higher level authority, or collaboratively as part of a team
• Must be flexible as to the changing needs of the center
• Bilingual- English/ Spanish preferred
• CPR certification recommended

Education and Experience:

High school diploma or equivalent

One (1) to three (3) year experience in field or related field

Hours:

Full Time, Monday-Friday 8:30 a.m.-5:00 p.m. or typical office hours

Locations:

Hartsville, SC

Proof of full vaccination for COVID-19 must be presented prior to beginning work with CareSouth Carolina.

CareSouth Carolina is committed to providing equal employment opportunities to all. We seek to have a diverse, inclusive workforce and encourage applications from all qualified individuals without regard to race, color, age, sex, gender identity or expression, sexual orientation, religion, marital status, citizenship, disability or veteran status.

Job Type: Full-time

Benefits:

• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Education:

• High school or equivalent (Preferred)

Experience:

• Insurance verification: 1 year (Preferred)
• Medical billing: 1 year (Preferred)

Work Location: In person

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