Referral Specialist

Where You’ll Work

CommonSpirit Medical Group (CMG) offers providers a true opportunity to live their calling to care while experiencing the support of a built-in comprehensive network, vast resources, professional growth, trusted leadership, generous benefits and an amazing quality of life with locations in Colorado, Kansas and Utah. CMG is proud to connect providers and consumers through state-of-the-art technology, clinical resources and professional expertise to help people live healthier. Our coordinated services represent a full continuum of care – from preventive and early diagnoses to leading-edge treatment and life-saving critical care. CMG’s ability to deliver better health care value is the direct result of combining the best clinical tools, shared resources and medical expertise with a patient-centered approach that emphasizes CommonSpirit Mountain Region’s mission and commitment to quality, compassion and service. 

Position is PRN: As Needed to Cover Shifts (6:00AM - 6:00PM, Variable Weekdays)

Job Summary and Responsibilities

As our Referral Specialist, you will manage telephone inquiries for physician and community service referrals, assist with appointments, and obtain insurance authorizations, benefits, and network status for patient transfers from primary to specialty care. Every day you will support call center functions by researching and maintaining databases, verifying insurance information, confirming specialty provider acceptance, and making inbound/outbound calls related to referrals, meticulously documenting all interactions. To be successful in this role, you will possess strong communication and customer service skills, expertise in insurance verification and payer platforms, and meticulous attention to detail in managing referrals and maintaining databases.

• Answer incoming phone calls and provide physician referral, class/program registration or community service referral.
• Provide accurate computer documentation of all telephone encounters. Obtain accurate information, including all pertinent data, precertification numbers, and patient demographic details.
• Verify insurance coverage and authorization requirements per patient plan and policy guidelines.
• Communicates promptly and liaises with patients, insurance companies, and physician's staff.
• Enter service referral information into database.
• Update/maintain on regularly scheduled basis.

Job Requirements

Required

• High School Diploma/G.E.D.
• Two (2) years related customer service experience
• Prior experience in a hospital admissions department, physician office, or similar healthcare setting
• Applicants must reside in Colorado to be considered