Medical Referral Specialist Resume Example Valley Medical Group

MEDICAL REFERRAL SPECIALIST

Professional Summary

A dedicated and proactive Referral Specialist, specializing in Insurance referrals, authorizations, clinical reimbursement, and overall quality patient care, start to finish. Organized professional who works well with a team as well as independently. Versatile Administrative professional well-versed in healthcare practices, compliance standards and operations. Excellent problem-solver and clear communicator with positive and upbeat personality.

Skills

Billing
Office equipment
Excellent customer service
Policies and Procedures
Prior authorization processing
Insurance coverage verification
Charting and clinical documentation

Product development
Multi-line telephone systems
Professional demeanor
Accounts payable and receivable
Office administration
Multitasking strengths
Performance improvement

Work History

Medical Referral Specialist, 07/2018 to Current
Valley Medical Group – Amherst, MA

Received, recorded and addressed incoming and outgoing communication via telephone and email.
Answered phone calls and messages for 60,000 patients, 50+ physician's at a primary care medical facility, scheduling specialty appointments and handling patient inquiries.
Successfully scheduled patient appointments and placed reminder calls to ensure exceptional customer experience.
Facilitated organized record retrieval and access by maintaining filing system for both in-house and out-side.
Specializing in Insurance Referrals, Prior Authorizations, and updating patients insurance information when needed.
Schedule all outside diagnostic testing
Documented patient medical information, case histories and insurance details to facilitate smooth appointments and payment processing.

Lead Receptionist, 08/2016 to 06/2018
Valley Medical Group – Florence, MA

Responsible for all Physical Therapy insurance referrals, authorizations, eligibility, patient registration, insurance verification's, log all Medicare POC, keep track of visits and benefit policies for each and every patient.
Directly deal with difficult, upset, or confused patients in the most dignifying, professional, and compassionate manner.
Work directly with the billing department to ensure accurate reimbursements and clinical documents are being submitted in a timely manner.
Responsible for updating and training the receptionist with the most current insurance information, policies and procedures, and changes for all specialties and family practice.
Collect copay's, bad debt, balances, and logs the daily transactions.
Acting supervisor when reception coordinator is not present.
Provided clerical support to 50 company employees by copying, faxing and filing documents.
Collected and distributed messages to team members and managers to support open communication and high customer service.
Assisted internal staff with clerical and administrative needs to maximize efficiency and team productivity.
Answered inquiries and resolved or escalated issues to management personnel to ensure client satisfaction.

Rehab Office Coordinator, 07/2013 to 06/2015
Genesis HealthCare – Hadley, MA

Supervised by Therapy Program manager, Brief PM on therapy caseload, resident and therapist schedules, all created in ROX.
Tracking all therapy minutes in Rehab Optima, setting RUG levels, and going through projections to plan out minutes.
Completed all technical audits of charts, ensuring all documents are present, monthly submitted to cooperate.
Maintains all filing for therapy department, photocopying, faxing,.
Responsible for all department scheduling, full time, part time, and per-diem staff.
Ensures all therapist licenses are current and posted.
Track all physician referrals, evaluations, orders, and signatures.
Stocking and ordering all supplies.
Attend morning meeting with Administration and nursing staff, keeping a log of daily minutes,briefing therapist on relevant changes, maintained a positive working relationships with all of the departments.
Assist with survey compliance.
Daily temp logs, sending out equipment for re- calibration, and in-servicing and orienting all staff and new hires.
Made sure all therapist payroll(s) are accurate and submitted in a timely manner.
Persistent in getting Insurance authorizations, ARD' s, Med B cuts, and Secondary Insurance.

Certified Nursing Assistant, 09/2008 to 06/2015
Genesis Health Care Neuro. and Orthopedics – Hadley, MA

Experienced in long and short term care, mental health, Neuro.
And Orthopedics.
Assist residents with ADL's.
Assisting nursing with treatments, procedures, or other medical necessities.
Responsible for charting on all residents ADL's electronically in PCC.
Deliver patient care with sensitivity and ensure patient dignity.
Accompanied residents on doctor's appointments, gathering all necessary items and documentsneeded.
Upon Admission, obtain appropriate equipment such as walkers, canes, and wheeled chairs.

Education

Certification: CNA, 09/2008
Red Cross - Springfield, MA

Nursing Program: 2009
Holyoke Community College - Holyoke, MA

Early Childhood Special Education, 2007
Greenfield Community College - Greenfield, MA

High School: 05/2005
Hopkins Academy - Hadley, MA

Resume Overview

Companies Worked For:

Valley Medical Group
Genesis HealthCare
Genesis Health Care Neuro. and Orthopedics

School Attended

Red Cross
Holyoke Community College
Greenfield Community College
Hopkins Academy

Job Titles Held:

Medical Referral Specialist
Lead Receptionist
Rehab Office Coordinator
Certified Nursing Assistant

Degrees

Certification : CNA , 09/2008
Nursing Program : 2009
Early Childhood Special Education , 2007
High School : 05/2005

Medical Referral Specialist Resume Example

Resume Score: 80%

Resume Overview

Create a job alert for [job role title] at [location].

Similar Resumes