This is a fully remote position, open to applicants in Massachusetts.

📋 Description

• Initiate and manage insurance referral requests for patients at BILH Primary Care Practices.

• Coordinate and process authorization requests for specialty care managed care referrals across various insurance payers.

• Utilize electronic systems to initiate, issue, and finalize a high volume of referrals efficiently.

• Act as a primary point of contact and resource for patients, families, specialty practices, physicians, and support staff regarding managed care matters.

• Communicate authorized levels of care, visit counts, and the scope of diagnostic testing to both specialists and patients.

• Resolve issues related to referral management with managed care payers and work collaboratively with both internal and external customers to address billing concerns.

• Provide training on referral management to new employees.

• Stay informed about referral and authorization policies across various payers, specialties, and diagnostic tests.

• Retrieve referral requests from Clinical Computing, Patient Site, OMR notes, emails, nurse triage, and patient voicemails; process referrals and communicate updates promptly.

• Work collaboratively with the team to address referral management issues and inquiries for new patients.

⛳️ Requirements

• High School diploma or GED is mandatory.

• Medical Administrative Assistant Certification is preferred.

• Required experience of 1-3 years in a related field.

• Proficiency with computer systems is essential, including web-based applications and some Microsoft Office programs such as Outlook, Word, Excel, PowerPoint, or Access.

• Must comply with patient confidentiality regulations.

• Vaccination against influenza (flu) is required as a condition of employment.