Referral Specialist, Hybrid- Northampton

We are seeking a full-time, 40-hour Referral Specialist to join our team! This position follows a Monday-Friday schedule from 8:30am to 5:00pm, located at 22 Atwood Dr., Northampton, MA 01060. It offers a hybrid work opportunity, typically requiring 2 days on-site and 3 days remote per week. The schedule is flexible based on departmental needs. During the first 90 days, employees are expected to be onsite for all hours worked for onboarding and training. After successful training completion, hybrid work rotation options are available, contingent on performance.

The Referral Specialist is responsible for ensuring third-party payer referral requirements are met. Responsibilities include:

• Receiving and processing specialty referral orders from providers or patients via the electronic health record system.
• Verifying insurance benefits and obtaining necessary authorizations or re-verifications prior to patient visits or admissions.
• Providing referral and patient information to patients, payers, specialists, and healthcare providers, and guiding them through referral process requirements.
• Assisting providers with obtaining diagnosis codes, procedure codes, and pricing information.
• Documenting all referral processing steps and interactions in the electronic health record system.
• Following up on pending referrals and obtaining progress notes from specialists.
• Maintaining compliance with organizational policies, confidentiality, quality improvement, safety, infection control, and environmental standards.
• Engaging in professional development activities to stay current in the field.
• Meeting annual competency and retraining requirements.
• Attending meetings as required and performing other duties as assigned.

Qualifications:

• High School Diploma or Equivalent required; Master's Degree in a related field preferred. This role does not accept experience in lieu of a degree.
• Experience in healthcare, particularly in referral coordination or related administrative roles, preferred (1-2 years).
• Knowledge of medical terminology, insurance processes, and referral procedures is beneficial.
• Familiarity with EHR systems and scheduling software.
• Excellent organizational, time management, communication, and interpersonal skills.
• Attention to detail and proficiency with office software applications.

Mass General Brigham Medical Group Western Massachusetts, Inc. is an Equal Opportunity Employer. We embrace diversity and are committed to providing accommodations for individuals with disabilities throughout the employment process.