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Referral Specialist II

Mosaic Health
Full-time
On-site
Apple Valley, California, United States

Job Description Summary

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Responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals.

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How will you make an impact & Requirements

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Primary duties may include, but are not limited to:

  • Acts as a first level SME, ability beyond intake calls that include working on production oriented work, may include physician assisting and/or special projects.

  • Acts as liaison between hospital, health plans, physicians, patients, vendors and other referral sources.

  • Reviews complex referrals for completeness and follows up for additional information if necessary.

  • Assigns referrals to staff as appropriate.

  • Verifies insurance coverage and obtains authorizations if needed from insurance plans.

  • Contacts physician offices as needed to obtain demographic information or related data.

  • Enters referrals, documents communications and actions in system.

  • Enters referrals, documents communications, actions and other data in system.

Requirements:

  • Requires HS diploma or GED

  • Minimum of 1 year experience and a minimum of 1 year of experience in a high-volume, interactive customer service or call center in a healthcare environment; or any combination of education and experience which would provide an equivalent background.  

  • Knowledge of medical terminology, plan specific guidelines; ICD-9 and CPT coding preferred.

Compensation:  $23/hr. - $25/hr. & bonus eligible 

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