Home Health Focus AI · 8 hours ago
Referral Specialist-Remote
Jackson, TN
Full-time
Remote
Entry Level
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Responsibilities
The referral specialist will receive authorization requests from the clinical team
The referral specialist will collect the needed information to complete the authorization request including clinical data retrieved from an EMR or specialist practice and submit the authorization request to the health plan team.
The referral specialist may review in-network and non-par provider lists as well as local maps to determine the appropriate specialist for referral.
The referral specialist will systematically track the requests submitted and follow up with clinicians upon completion.
Qualification
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Required
Communication skills and active listening via telephone conversations with clinicians and health plan staff
Be able to manage multiple tasks and input from various sources
Be able to organize and prioritize work for completion and follow up
Proficiency with medical terminology
Able to organize and communicate effectively via email
To have familiarity with ICD-10 and CPT codes
Great telephonic and customer service skills
Gather clinical data for review
High School or equivalent required
Self-starter needed and potential for work from home option if productivity demonstrated.
Microsoft Office including Outlook, Excel and Word
Basic EMR
Standard Office Equipment
Computer
eFax
Working safely and follow safety rules
Report unsafe working conditions and behaviors
Take reasonable and prudent actions to prevent others from engaging in unsafe practices
Does not have direct supervisory responsibilities
Supervisor frequently determines priorities
Occasionally needs manager’s direction due to extraordinary circumstances
Preferred
Medical assisting and/or medical back office experience strongly preferred.
Medical Assisting certification preferred
Company
Home Health Focus AI
HomeHealthFocus.ai is an innovative data platform that tracks and analyzes critical information from home care, hospice, and senior living companies across the United States.
Founded in 2024
2-10 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase
