Referral Specialist - Full Time

Location: Lakwood Ranch, FL - Onsite: In-Person Monday to Friday Day

Position Summary:

A Medical Referral Specialist manages the process of sending patients to other healthcare providers or specialists, acting as a liaison between patients, providers, and insurance companies. Key duties include verifying patient insurance, obtaining pre-approvals and authorizations, coordinating appointments, tracking referral statuses, and documenting all relevant information in the patient's record. This role requires excellent communication, organizational skills, and familiarity with medical insurance plans to ensure patients receive the care they need.

Key Responsibilities

Insurance Authorization & Verification: Confirming patient eligibility and benefits with insurance providers to ensure that specialty services are covered.

Referral Processing: Initiating, tracking, and following up on referral requests to specialty providers.

Liaison and Communication: Serving as a central point of contact for patients, referring providers, specialists, and insurance companies, managing communications between all parties.

Documentation: Maintaining accurate and up-to-date records of all referral activities, including patient history, diagnosis, and consult reports.

Patient Education: Informing patients about referral requirements, appointment details, and the overall referral process.

Appointment Coordination: Scheduling appointments with specialist providers and ensuring patients receive reminders.

Data Management: Entering and updating patient information and medical records in the Electronic Health Record (EHR) system.

Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve.

As a Manatee Physician Alliance employee you will be part of a first class organization offering:

• A Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match

About Universal Health Services (UHS), Inc.

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $14.3 billion in 2023. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies.

Headquartered in King of Prussia, PA, UHS has approximately 96,700 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

Education:
High school graduate or GED required.

Work experience: Minimum of two years' experience in a healthcare or clinical setting.

Knowledge:

Knowledge of clinical terminology, insurance billing, procedural and diagnosis coding, federal and state insurance regulations and HIPAA privacy standards is strongly preferred.

• Typing, 10 key and computer skills required.
• Proficiency in Microsoft Office applications required.
• Required effective interpersonal skills and excellent written, oral communication skills required.
• Acute healthcare knowledge and ability to evaluate clinical data to acquire pre-authorizations and referrals is preferred. Knowledge of third-party reimbursement regulations is preferred.
• Patient Management, Billing and Managed Care system processes competency. Understanding of functions and workflow of Clinical/Hospital departments.
• Excellent planning and organizational skills. Demonstration of strong analytical skills and problem-solving abilities. Strong teamwork skills and the ability to effectively communicate with all management levels.
• Results oriented, independently goal directed, able to multi-task and meet established time frames.
• Excellent customer service skills and must be able to work independently

Strong Communication: Excellent verbal and written communication skills are crucial for interacting with patients, providers, and insurance staff.

Organizational Skills: The ability to manage multiple referrals, maintain records, and multitask in a fast-paced environment is essential.

Insurance Knowledge: Expertise in understanding various medical insurance plans and their authorization processes.

Computer Proficiency: Familiarity with computer systems, including electronic health records, is required.

Customer Service Focus: A patient-centric approach to provide support and address patient concerns effectively.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.

Notice

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852- 3449