Referral specialists typically work in office settings within the medical field, and are responsible for ensuring that a patient's insurance allows them to access the services of the specialist's health care provider. They also handle the pre-certification of procedures which require the approval of insurance companies. They generally report to an immediate supervisor, but larger practices may employ one specialist to oversee the others. An associate's degree and/or approximately two years of work experience are generally required for the position.
Because referral specialists work with many different kinds of people, excellent written and oral communication skills are absolutely necessary. Much of their work is done on a computer, so knowledge of e-mail and basic computer programs is also important. This job often requires data entry to maintain patient files, as well.
Referral specialists must also work well under pressure (multitasking included) as they often deal with multiple patients in various stages of the approval process. They must also be familiar with medical terminology in order to communicate effectively with insurance providers.
Referral specialists generally work full-time (40 hours per week), but this may vary depending on the employer, and larger practices often employ more than one specialist. Much of their work is done on the computer and the phone, so this a largely sedentary position.
Referral Specialist Tasks
Schedule and confirm patient diagnostic appointments, surgeries and medical consultations.
Maintain referral records and report on data.
Performs patient referrals and authorizations by completing and submitting documents and discussing with providers, insurance carriers and patients.
Ensure that follow-up referral appointments and reports were kept and received.
Prepare medical records prior to patient visit.