Description
Are you detail-oriented, organized, and passionate about healthcare support services? Virtual Staffing Solutions is currently expanding and is looking for Referrals Escalations Representatives to deliver high-quality, support that ensures timely care for patients.
Key Responsibilities
- Obtains and processes referrals from providers and communicates authorizations with patients (via phone & mail) and medical staff in a timely manner.
- Prepares, processes, and completes referrals accurately and in a timely manner, including urgent and stat referrals for assigned members.
- Tracks referrals in the electronic medical records (EMR) system; Follows up on submitted authorization requests and maintains consistent status updates via EMR.
- Manages the need for redirection across all clients and payers by working with clinical teams to ensure timeliness of re-authorization ahead of expiry to avoid lapses in authorization or delays in patient care.
- Reviews consultation reports for needed follow up requests and works with providers to ensure timely processing of all follow ups.
- Works with the health information (medical records) department to ensure timely retrieval of consultation reports.
Skills, Knowledge & Expertise
- Minimum of 1 year BPO experience in the US medical billing, particularly in referrals
- Preferably with experience handling escalations concerning referrals
- Strong knowledge of US billing, collections, coding, and healthcare regulations
- Experience in assigning ICD-10 and CPT codes is an advantage
- Excellent written and verbal communication skills
About Virtual Staffing Solutions
We specialize in delivering innovative solutions and exceptional services to meet the diverse needs of our clients. With a strong commitment to quality and customer satisfaction, we strive to exceed expectations and drive success in every project we undertake.
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