Job Description
Job DescriptionDescription:
Precision Healthcare Specialists is a trusted healthcare group committed to delivering quality patient care and seamless medical services. We are seeking a detail-oriented HMO Referral Specialist to manage referrals and insurance verifications for our patients within Health Maintenance Organization (HMO) networks
- Process and coordinate referrals to in-network specialists and other healthcare providers.
- Verify patient eligibility and benefits for HMO plans
- Submit and track referral requests, ensuring timely approvals.
- Maintain communication with patients, providers, and insurance companies regarding referral status.
- Accurately document all referral requests and approvals in the Practice Management (PM) system.
- Educate patients on referral policies and insurance requirements.
- Ensure compliance with HMO guidelines, HIPAA regulations, and company policies.
Schedule:
Monday - Friday
8:30AM to 5:00PM
Requirements:
- High school diploma or GED required; associate's degree in healthcare administration or related field preferred.
- Minimum 2 years of experience in medical referrals, insurance verification, or HMO authorization processing.
- Strong knowledge of HMO plans, referral procedures, and insurance guidelines.
- Proficiency in PM, EMR systems and Microsoft Office Suite.
- Excellent customer service, communication, and problem-solving skills.
- Ability to multitask in a fast-paced environment and maintain attention to detail.