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Referral Specialist - 1016 image - Rise Careers
Job details

Referral Specialist - 1016

Department

Gastro PBB - 209589

Worker Sub Type

Regular

Work Shift

Pay Grade

107

Job Description

The Insurance and Referral Specialist coordinates the front end of the revenue cycle by processing pre-registration, registration, demographic and financial verification activities. The specialist analyzes insurance payor/plans and verifies eligibility through Epic’s RTE platform or third party websites, documents responses of eligibility accurately in the patient’s medical record. Coordinates with verification of insurance benefits for all patients within 48 hours of seminar attendance, calls patients within 72 hours of the seminar to communicate results of benefits verification and to schedule an initial consultation appointment. The specialist counsels patients with exclusions on self-pay and financing options and meet with each patient at the end of initial consultation appointment to discuss insurance and clinical requirements and the process to surgery. The Insurance and Referral Specialist is responsible for tracking patient status and entering all insurance and appropriate data in tracking tool. They collaborate with the bariatric patient navigators and other team members to ensure there is clear communication on insurance requirements, referring reason, patient preferences, etc. The Insurance and Referral specialist tracks referrals, responds to referring providers, contacts referred patients to initiate care and ensures referrals are completed properly.

Education
High School Diploma or GED required*
* Five years medical clinic experience in lieu of degree

Experience
Five years customer service related experience required
Experience working in a medical clinic setting required
Three years working with insurance companies and obtaining authorizations preferred
Experience with ICD and CPT coding required


Qualifications
Strong computer skills required
Ability to demonstrate excellent judgment required
Excellent verbal and written communication skills required
Ability to accurately document patient status required
Ability to manage multi tasks/assignments simultaneously required
Ability to function as team member and promote teamwork required
Knowledge of EMR system preferred

FLSA Classification
Non-exempt

Physical Demands
6 A Customer Service

Benefits

At Valley Health, we believe everyone is a caregiver, and our goal is to create an environment where our caregivers thrive physically, financially, and emotionally. In addition to a competitive salary, our most popular benefits for full-time employees include:

  • A Zero-Deductible Health Plan
  • Dental and vision insurance
  • Generous Paid Time Off
  • Tuition Assistance
  • Retirement Savings Match
  • A Robust Employee Assistance Program to help with many aspects of emotional wellbeing
  • Membership to Healthy U: An Incentive-Based Wellness Program

Valley Health also offers a health savings account & flexible spending account for childcare, life insurance, short-term and long-term disability, and professional development. In addition, several perks come with working for the largest employer in the region, such as discounts to on-campus dining, and more.

To see the full scale of what we offer, visit valleyhealthbenefits.com.

Valley Health (Virginia and West Virginia) Glassdoor Company Review
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CEO of Valley Health (Virginia and West Virginia)
Valley Health (Virginia and West Virginia) CEO photo
Mark Nantz
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Average salary estimate

$52500 / YEARLY (est.)
min
max
$45000K
$60000K

If an employer mentions a salary or salary range on their job, we display it as an "Employer Estimate". If a job has no salary data, Rise displays an estimate if available.

What You Should Know About Referral Specialist - 1016, Valley Health (Virginia and West Virginia)

As a Referral Specialist at Valley Health in Winchester, Virginia, you’ll be at the heart of our operations, ensuring a smooth front-end revenue cycle that helps our patients receive the care they need. In this pivotal role, you’ll be processing pre-registrations, registrations, demographic and financial verifications, and much more, all while using Epic’s RTE platform or third-party websites to analyze insurance payors and plans. You’ll communicate with patients within 72 hours to discuss eligibility, self-pay options, and financing, establishing a supportive relationship right from the beginning. With your exceptional communication skills, you’ll collaborate closely with bariatric patient navigators and other team members to maintain clear and accurate communication about insurance needs and patient preferences. Tracking patient status and insurance data will be key responsibilities, ensuring everything is documented accurately. Additionally, you’ll respond to referring providers and actively manage the referral process to initiate care effectively. If you have strong computer skills, a knack for teamwork, and a passion for helping patients navigate their healthcare journey, this role is perfect for you. Join us at Valley Health and make a real difference in our community through your expertise and dedication!

Frequently Asked Questions (FAQs) for Referral Specialist - 1016 Role at Valley Health (Virginia and West Virginia)
What are the responsibilities of a Referral Specialist at Valley Health?

The Referral Specialist at Valley Health plays a crucial role in the revenue cycle by processing patient registrations, verifying insurance eligibility, and coordinating with patients after seminars for consultations. This includes tracking referrals, communicating important insurance information, and ensuring that patients are well-informed about their options.

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What qualifications do I need to become a Referral Specialist at Valley Health?

To become a Referral Specialist at Valley Health, you should have a High School Diploma or GED, with five years of customer service experience required, along with experience in a medical clinic setting. Experience working with insurance companies and knowledge of ICD and CPT coding is preferred, making strong communication skills essential for success.

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How does Valley Health support the well-being of its Referral Specialists?

Valley Health provides a supportive environment for its Referral Specialists, offering a range of benefits including a zero-deductible health plan, dental and vision insurance, generous paid time off, and an employee assistance program to promote emotional well-being. These perks all contribute to a satisfying work-life balance.

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What tools or systems will I be using as a Referral Specialist at Valley Health?

As a Referral Specialist at Valley Health, you will primarily use Epic’s RTE platform for verifying insurance eligibility, along with various medical coding systems and tracking tools to manage patient information and referrals effectively.

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What should I expect during the application process for the Referral Specialist position at Valley Health?

Candidates applying for the Referral Specialist position at Valley Health can expect an application review followed by interviews that focus on customer service skills, medical knowledge, and ability to manage multiple tasks, all of which are pivotal to this role in the healthcare setting.

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Common Interview Questions for Referral Specialist - 1016
Can you describe your experience with insurance verification?

Certainly! In previous roles, I have routinely engaged in verifying insurance eligibility through various platforms. I focused on documenting responses accurately and addressing any concerns while maintaining clear communication with patients about coverage options.

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How would you handle a patient who is unhappy about their insurance coverage?

I would approach the patient with empathy, listen to their concerns, and provide clear information about their options. It's crucial to reassure them that I’m here to help navigate their situation, discussing self-pay options or financing if necessary.

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What strategies do you use to manage multiple tasks and deadlines?

I prioritize my tasks based on urgency and importance. I use digital tools to track my responsibilities and ensure that I'm meeting deadlines, allowing me to stay organized and deliver exceptional service to each patient.

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How do you ensure accuracy in documentation and data entry?

I always double-check my entries and verify that the information aligns with the patient’s details. I find that taking a moment to confirm accuracy helps prevent mistakes, which is vital in a medical setting.

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Describe a time when you worked as part of a team to solve a problem.

In my previous position, our team faced a sudden influx of patients needing insurance verifications. We collaborated closely to share the workload and communicated effectively to ensure every patient received timely updates, which we successfully resolved.

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What role do you believe communication plays in the Referral Specialist position?

Effective communication is essential in the role of a Referral Specialist, as it builds trust with patients and ensures that all aspects of their care are coordinated smoothly among healthcare providers.

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How do you stay updated with changes in insurance policies and medical coding?

I regularly attend workshops and webinars, and I follow relevant industry publications. Staying informed allows me to better assist patients and adapt to any changes impacting insurance verification and coding practices.

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What is your approach to building rapport with patients?

I believe in being approachable and empathetic. By actively listening to patients’ concerns and providing clear explanations, I can make them feel supported and understood throughout their healthcare journey.

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In what ways do you think your past experience prepares you for the Referral Specialist role?

My extensive experience in medical clinics has equipped me with a strong foundation in insurance processes and patient interactions, allowing me to effectively contribute to the team from day one while understanding the needs of our patients.

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What methods do you use to ensure a smooth follow-up process for referrals?

I maintain organized records and follow up promptly with both patients and healthcare providers. By keeping communication channels open, I can track the status of referrals and address any barriers that arise quickly.

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Serving Our Community by Improving Health. As one system, we have one purpose: leading with innovative healthcare. Our focus always remains on patients first, rooted in our commitment to maintain integrity, excellence, courage, compassion, innova...

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Full-time, on-site
DATE POSTED
April 2, 2025

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