Referral Specialist Resume Samples

Working in the healthcare industry, the Referral Specialist will determine if the patient’s insurance firm allows them access to certain medical services. A Well-drafted Referral Specialist Resume mentions the following duties and tasks – scheduling patient appointments, maintaining medical records, retrieving medical records, updating referral records, handling pre-certification of procedures; completing patient authorizations, and reporting data to supervisors.

Those seeking to work as Specialists for the healthcare field must denote the following skills and abilities – knowledge of insurance procedures and medical terminologies; excellent written and oral communication; confidentiality, knowledge of email and basic computer programs, and data entry skills. As the job is of sedentary in type, the person should be prepared to do the same job repeatedly and be willing to travel if needed. Formal education is not mandatory, but training in healthcare administration is mandatory.

 

Referral Specialist Resume

Headline : In order to achieve in your company, I will use my skills and qualities to strive for the growth of the company. Iam goal oriented and determined.With my Integrity, loyalty, dependability and organization skills, I will always strive to improve the productivity of the company.

Skills : Microsoft Office, Windows 7, Windows Vista.

Description :

    1. Explain magnetic resonance imaging (MRI) procedures to patients, patient representatives, or family members.
    2. Conduct screening interviews of patients to identify contraindications, such as ferrous objects, pregnancy, prosthetic heart valves, cardiac pacemakers, or tattoos.
    3. Request sedatives or other medication from physicians for patients with anxiety or claustrophobia.
    4. Schedule appointments for research subjects or clinical patients.
    5. Take brief medical histories from patients.
    6. Schedule and confirm patient diagnostic appointments, surgeries, or medical consultations.
    7. Software applications to prepare reports, invoices, financial statements, letters, case histories, or medical records.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Veterinary Assistant


Information Referral Specialist Resume

Objective : Referral Specialist adept at verifying insurance coverage, reviewing records, scheduling exams and updating information. Previously supported up to 5 physicians in a busy medical office setting.

Skills : Database Management, Management, Medical Records, Data Entry, microsoft office, Web Services, Customer Service, Administrative Support.

Description :

    1. Scheduled appointments, registered patients and distributed sample pharmaceuticals as prescribed.
    2. Professionally and courteously verified appointment times with patients.
    3. Assisted in the maintenance of medical charts and/or electronic medical record, filing, Reports, test results, home care forms.
    4. Adeptly managed a multi-line phone system and pleasantly greeted all patients.
    5. Verified patients' eligibility and claims status with insurance agencies.
    6. Prepared patient charts accurately and neatly for the clinic.
    7. Prepared patient charts, pre-admissions and consent forms as necessary.
    8. Determined prior authorizations for medication and outpatient procedures.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
Medical Office Administration


Referral Specialist/Medical Assistant Resume

Objective : To obtain a position within the medical field that is meaningful and challenging; that contributes to my daily knowledge and growth as a medical professional.

Skills : Microsoft Office, PowerPoint, Excel, Outlook, EMR, EClinicals,.

Description :

    1. Responsible for communication with the patient's insurance provider to receive a prior authorization on referred services or specialty care.
    2. Responsible for processing referrals for patients as ordered by the provider.
    3. Responsible for communicating with the referring physician when additional information is required to complete the referral.
    4. Accountable that all relevant records are sent to the referred service provider to schedule appointment.
    5. Mail/Email information packets to patient for specific specialist.
    6. Maintains strict confidentiality with regards to patient information.
    7. Participates in staff meetings Cross trains and performs other office duty including phone coverage, precertification, scheduling.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
Certificate In Medical

Referral Specialist/Billing Representative Resume

Objective : A responsible, dedicated, formally trained and committed Professional seeking to join a growing organization to increase corporate bottom line. A meticulous professional who has firm grasp of this industry.

Skills : Microsoft Office, Conversational Spanish.

Description :

    1. Processing of outpatient waiver and some inpatient authorizations listed within TruCare system.
    2. Keep up with updates and changes in policy and procedures as well as being able to adapt and learn system use for CRM, Amisys, WebCM and Trucare.
    3. Timely completion and accurate data entry of all home based services task.
    4. Research, correct or update any authorizations that show up on any error report received from claims.
    5. Attend training and compliance sessions as scheduled.
    6. Complete custodial auths for LTC members, which includes closing, opening, or discharging authorizations when a member leaves or returns to a nursing home.
    7. Monthly maintenance of termed member spreadsheets.
    8. Work on special projects assigned by supervisor Various other duties.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
Diploma

Patient Referral Specialist Resume

Objective : Highly enthusiastic customer service representative with 4+ years client interface experience. Core Strengths Multi-line phone usage Strong organizational skills MS Windows proficient Energetic work attitude Fast learner Adaptability.

Skills : Bilingual English / Spanish - STARS MS Office 2007, Internet Explorer, PeopleSoft, Banner, Sophas, Epic For Registration, Confirmation Of Medical Insurance, Also Infinite To Schedule, Confirm, Or Change Doctor's Calendars.

Description :

    1. Reviewed and analyzed all referral incoming and outgoing for patients as per requested also answered, screened and routed calls.
    2. Obtain appropriate authorization, and assured referrals are maintained within appropriate networks Pre-Registered.
    3. Coordinated, Scheduled and Verified appointments with specialty office and patient.
    4. Ensured Roundtrip Transportation for patients Documented referrals made and prepared summary reports as requested.
    5. Filed loose papers into records, pulled/refilled records.
    6. Prepared records for patient appointments, and delivered records.
    7. Received, processed, and respond to paper and electronic requests for medical records.
    8. Scanned and index documents into the electronic health records practice management system.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
Secretarial Science

Referral Specialist Supervisor Resume

Summary : Dedicated Customer Service Representative motivated to maintain customer satisfaction and contribute to company success.

Skills : Photography, Data Entry, Administrative Skills, Organization, Effective Communication Skills, Written Communication, Customer Service, Typing, Actress, Microsoft Word, Microsoft Office, Microsoft Excel.

Description :

    1. Responsible for making physician referrals and appointments for clients of all ages with participating physician offices.
    2. Selected service referrals, perform outbound calls and surveys as directed, update computer database information related to physicians and services.
    3. Function as an answering service for organ and tissue procurement service calls.
    4. Process telephone notification of injury calls and other types of occupational health-related inquiries.
    5. Answer and direct calls for various answering service clients.
    6. Market products, physicians and services to all callers as appropriate.
    7. Gather basic information pertinent to all calls and direct calls appropriately, and carry out clerical tasks as assigned.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Bachelors In Management

Referral Specialist Lead Resume

Summary : Experienced medical office professional with over 10 years experience in working within clinical settings. Skilled in optimizing clinic workflows by managing patients flows, physician schedules, and patient appointments. Strong administrative skills, including inventory management, accounts receivable, and patient records management. Seeking to obtain employment with a highly respected healthcare organization dedicated to producing positive patient outcomes and delivering exceptional customer service.

Skills : Office Administration.

Description :

    1. Greet visitors, ascertain purpose of visit, and direct them to appropriate staff.
    2. Answer telephones and direct calls to appropriate staff.
    3. Schedule and confirm patient diagnostic appointments, surgeries, or medical consultations.
    4. Receive and route messages or documents, such as laboratory results, to appropriate staff.
    5. Transmit correspondence or medical records by mail, e-mail, or fax.
    6. Perform various clerical and administrative functions, such as ordering and maintaining an inventory of supplies.
    7. Perform bookkeeping duties, such as credits or collections, preparing and sending financial statements or bills, and keeping financial records.
    8. Schedule tests or procedures for patients, such as lab work or x-rays, based on physician orders.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
High School Diploma

Medical Referral Specialist Resume

Summary : Utilize a challenging and rewarding position in front office in a growth oriented organization where my administrative, front office and communication skills will add value and exceptional service.

Skills : Microsoft's Excel, Access, Word Document, Outlook,.

Description :

    1. Communicated with Payers, Adjusters, Employees and Patients as appropriate and as per protocol.
    2. Obtained authorization for referrals to generate scheduling.
    3. Received faxes and post into the Fax Library and direct to Coordinators if appropriate.
    4. Answered all emails and voicemails from the CSS mailbox and fulfill the request.
    5. Built relationship with providers, patients and payer community.
    6. Created, processed, authorized referrals when appropriate to Case Managers.
    7. Answer phone cues and faxes within established standards Initiated authorization requests for output or input services in keeping with the prior authorization list.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Consultant
Education
Education
Medical Assistant

Referral Specialist II Resume

Objective : A detail-minded individual combining strong interpersonal and communication skills with experience as a Customer Service, Retention, Quality Assurance, Technical Support, Data Entry, and Accounting Specialist. Eager to advance my career, bring new ideas and attributes to your company.

Skills : Clia testing, Injections / Immunizations, Customer Service, Data Entry, Maintaining Inventory, Windows, Patient Care, Wordperfect, Vital Signs, Telephone Skills.

Description :

    1. Responsible for Inbound phone inquires from providers.
    2. Initiate authorization requests for output or input services in keeping with the prior authorization list Enter all appropriate Medicare authorizations into Trucare System.
    3. Process referrals and refer, to case managers when appropriate.
    4. Screen for eligibility and benefits, Maintains records by making copies; filing documents.
    5. Protects organization's value by keeping information confidential.
    6. Maintains database by entering new and updated customer and account information.
    7. Prepares source data for computer entry by compiling and sorting information.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
Diploma

Referral Specialist I Resume

Objective : Personable, high-energy, reliable, service-oriented nursing professional with excellent patient-care and charting skills. Over 20 years' experience in Telemetry, Cardiology, Pediatric, Neurology, Intensive Care, Nephrology, Emergency, Orthopedics, Oncology and Skilled Facility. I'm very passionate in my career and give the best care to my patients.

Skills : Microsoft Office.

Description :

    1. Approved and provided authorization number for all interoffice referrals.
    2. Ensured all referrals were addressed in a timely manner.
    3. Scheduled all appointments for various clinics at MIHS (Maricopa Integrated Health System).
    4. Ensured inmates prior approval requirements were met.
    5. Present necessary medical information such as history, diagnosis and prognosis.
    6. Provide all medical information to the contracted hospitals.
    7. Faxed all information to Maricopa Integrated Health System.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
Certified Nursing Assistant

Referral Specialist III Resume

Summary : Ability to type 45-50 wpm Outstanding filing and organizational skills SAP Knowledge Knowledge of all Microsoft Suite programs Knowledge of PeopleSoft software programs and Oracle Basic understanding ICD-9 and CPT coding.

Skills : Microsoft Office, Sap, Peoplesoft, Customer Service, Data Entry.

Description :

    1. Provided support to a clinical team in order to facilitate the administrative components of clinical referrals for various AIM services.
    2. Initiated and managed clinical referrals for pre-authorization.
    3. Acted as a liaison between hospital, health plans, physicians, patients, vendors and other referral sources.
    4. Reviewed referrals for completeness and follows up for additional information if necessary.
    5. Assigned escalated referrals to staff as appropriate.
    6. Verified insurance coverage and completed pre-authorization process for radiology and other imaging exams (CT, MRI, MRA, PET, et.) following established process and procedures.
    7. Responded to inbound calls initiating exam requests following established processes, met quality and production standards.
    8. Contacted physician offices as needed to obtain demographic information or related data.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Dental Assistant

Referral Specialist Resume

Summary : Certified Medical Assistant with expert knowledge of medical terminology and HIPPA compliance. Devoted and hard working with established career working in Infectious disease and family care settings. Support quality patient care and education.

Skills : Flexibility, Customer Service, Computer Skills, Phones, Typing 50 Wpm, Medical Terminology, Medical Coding, Analytical, Receptionist, Imasis Software, Peoplesoft, Leadership, Volunteer, Listening, Teaching.

Description :

    1. Coordinate calls to hospitals, specialty practices, and others services.
    2. Attaining authorizations from insurance companies for the patient referral and recording all documentation pertaining to the referral for patient files.
    3. Patient follow-up required: follow patient show/no show, data entry from referral service provider, letter acknowledgement to patient if reschedule is necessary.
    4. Process follow-up, ensuring patient receives proper treatment.
    5. Must understand medical coding & terminology pertaining to patient care and reason(s) for referral services.
    6. Must provide excellent people and professional skills; communicate with patients, providers, and insurance carriers throughout the process.
    7. Responding to the needs of our patients with prompt, courteous information & service.
Years of Experience
Experience
10+ Years
Experience Level
Level
Senior
Education
Education
Associates