Talent.com
Health Plan Referral Specialist
Health Plan Referral SpecialistHJ Staffing • Irving, Texas, United States
Health Plan Referral Specialist

Health Plan Referral Specialist

HJ Staffing • Irving, Texas, United States
Hace más de 30 días
Tipo de contrato
  • A tiempo completo
Descripción del trabajo

We are seeking a Health Plan Referral Specialist to join our healthcare system team in Irving, TX. This is a critical role responsible for processing all referral authorization requests, researching claims, and ensuring our members receive timely access to the care they need.

You will act as a vital resource for both medical staff and patients, ensuring that the "behind-the-scenes" mechanics of insurance authorizations run smoothly and accurately.

What You Will Do

  • Authorization Management: Expedite the flow of requests through the Managed Care System. You will verify eligibility, benefits, and chart availability to ensure all forms are completed correctly.
  • Data Integrity: Accurately enter referral information into our system. A deep understanding of system codes (type, status, procedure, etc.) is essential.
  • Communication & Coordination: Notify patients, providers, and payers (HMO/PPOs) of authorization decisions. You will also coordinate the initiation of Home Health, DME services, and diagnostics as directed by clinical staff.
  • Tracking & Reporting: Utilize our tracking systems to monitor referral flow, measure turnaround times, and generate reports for management.
  • Resource Expert: Serve as the go-to contact for staff regarding managed care systems and contracted provider networks. You will also guide patients through the authorization requirements of their specific insurance plans.
  • Administrative Support: Assist in referral research for billing and collections and maintain updated medical files for all authorized activities.

What You Will Bring

  • Education: High School Diploma or equivalent (Required – proof must be submitted). An Associate's degree or higher in an allied health field is preferred.
  • Experience: 2+ years of experience working in a hospital setting, physician's office, or managed care organization.
  • Technical Skills: Working Knowledge of medical terminology and CPT background, typing skills, and knowledge of computers
  • Interpersonal Skills: Ability to interface professionally with insurance representatives, providers, and patients to resolve complex needs.

Important Position Details

  • Work Environment: This position is 100% onsite in Irving, TX. No remote work is available for this role.
  • Client Profile: Our client is a comprehensive health system that operates both hospitals and a health plan.
Crear una alerta de empleo para esta búsqueda

Health Plan Referral Specialist • Irving, Texas, United States

Ofertas similares

TCHATT Clinical Referral Specialist - Remote

JPS Health NetworkGrapevine, TX, United States
Teletrabajo
A tiempo completo

Who We AreJPS Health Network is a $950 million, tax-supported healthcare system in North Texas.Licensed for 582 beds, the network features over 25 locations across Tarrant County, with John Peter S...Mostrar más

 • Oferta promocionada

ECMO Specialist

Methodist Health SystemIrving, TX, US
A tiempo completo

X3 Day (United States of America).The ECMO specialist participates in the development of a treatment plan, involving assessment, planning, implementation, and education.Communicates with the ECMO p...Mostrar más

 • Oferta promocionada

Mental Health Therapist - Flexible Schedule

SonderMind CareersEuless, TX, US
A tiempo completo

SonderMind is a leading mental health care platform revolutionizing therapy services by empowering licensed mental health therapists to deliver exceptional care with cutting-edge, AI-powered tools....Mostrar más

 • Oferta promocionada

RN Behavioral Health Assessment Specialist (Night Shift)

Lifepoint Health®Carrollton, Texas, United States
A tiempo completo

A leading healthcare organization in Carrollton, Texas is seeking an Assessment Specialist RN for a full-time night shift position, Monday through Thursday.This role involves assessing patients, co...Mostrar más

 • Oferta promocionada

PRN Licensed Therapist - Inpatient Behavioral Health

Perimeter Healthcare CareersArlington, Texas, United States
A tiempo completo

A leading mental healthcare provider in Arlington, TX, is seeking a Licensed Therapist.In this role, you will conduct psychosocial assessments, develop treatment plans, and lead group therapy sessi...Mostrar más

 • Oferta promocionada

Hospitalist & Leadership Opportunities I No On-Call Duty| 20+ Days Off Per Month| $4200 per shift

HealthEcareers - ClientWaxahachie, TX, USA
A tiempo completo

Baylor Scott & White Medical Center – Waxahachie, Texas.OB/GYN Hospitalist Opportunities.Baylor Scott & White Medical Center in Waxahachie.Waxahachie community since 1914.It is home to six private ...Mostrar más

 • Oferta promocionada

Mental Health Therapist (New Compensation & Benefits)

BetterHelpArlington, TX, United States
A tiempo completo

Private practice with no doors and no overhead.BetterHelp is one of the world’s largest online therapy platforms for mental health professionals who want to focus on client care — not admin or over...Mostrar más

 • Oferta promocionada

Director of Assessment & Referral (Admissions) - Behavioral Hospital

Perimeter HealthcareArlington, TX, US
A tiempo completo
Quick Apply

About Perimeter Behavioral Healthcare Perimeter Behavioral Healthcare is one of the leading mental and behavioral healthcare providers in the country.We deliver hope through comprehensive and dedic...Mostrar más

Remote Behavioral Health Specialist

Monogram Health IncWaxahachie, TX, United States
Teletrabajo
A tiempo completo

Job DescriptionJob DescriptionPosition :Behavioral Health SpecialistCandidates must currently be licensed as an LCSW in either AZ or TX to qualifyMonogram is seeking a Behavioral Health Specialist ...Mostrar más

 • Oferta promocionada

Travel Physical Therapist (PT) - $1,817 to $2,137 per week in Waxahachie, TX

AlliedTravelCareersWaxahachie, TX, US
A tiempo completo

AlliedTravelCareers is working with Centra Healthcare Solutions to find a qualified Physical Therapist (PT) in Waxahachie, Texas, 75165!.Centra Healthcare Solutions is seeking a Physical Therapist ...Mostrar más

 • Oferta promocionada

Patient Care Technician - Entry Level Training Program

DreamboundWaxahachie, Texas, United States
A tiempo completo

Note : This is an educational program, not a job.Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market.Looking to ...Mostrar más

 • Oferta promocionada

Health Plan Credentialing/Payer Enrollment Specialist

Catalyst Consulting - The Business of MedicineArlington, TX, United States
A tiempo completo

Job Posting: Health Plan Credentialing/Payer Enrollment Specialist.Provider Enrollment Specialist.Competitive Based on Experience.A nationally recognized medical practice consulting firm seeks an e...Mostrar más

 • Oferta promocionada

RN: Behavioral Health Assessment Specialist

Memorial Physician PracticesCarrollton, Texas, United States
A tiempo completo

A healthcare organization in Carrollton, TX seeks an experienced nurse to facilitate patient admissions and assessments in a behavioral health setting.Candidates should have graduated from an accre...Mostrar más

 • Oferta promocionada

Integrated Health Management Manager

AccentureIrving, TX, United States
A tiempo completo

Job Description Accenture is a global leader in professional services, helping organizations worldwide transform their operations, enhance their growth, and deliver sustainable outcomes across indu...Mostrar más

 • Oferta promocionada

Infection Prevention and Control Technical Specialist - Remote

TradeJobsWorkForce75229 Dallas, TX, US
Teletrabajo
A tiempo completo

Infection Prevention and Control Technical Specialst Job Duties: Consolidate, review and revise Americares existing technical materials related to disease outbreaks, infection prevention and contro...Mostrar más

 • Oferta promocionada

Retirement Plan Operations Specialist

Guidant FinancialArlington, TX, US
Teletrabajo
A tiempo completo
Quick Apply

This is a fantastic opportunity to work from the comfort of your own home! We are excited to offer a fully remote position with a reputable and thriving company.Currently, we are recruiting in sele...Mostrar más

Field Care Manager, LTSS (RN) - Local Travel Required

Molina HealthcareBedford, TX, US
A tiempo completo

Opportunity for a Texas licensed RN to join Molina as a Field Care Manager to work with our Medicaid members in the communities of Hurst, Euless, and Bedford in the Fort Worth service delivery area...Mostrar más

 • Oferta promocionada

Remote Healthcare Talent Liaison

MLee Healthcare Staffing and Recruiting, IncArlington, TX, United States
Teletrabajo
A tiempo completo

Remote Healthcare Talent Liaison.Navigate your career path as a healthcare talent liaison empower change from anywhere.Have you considered that your next career step might be more than just a job? ...Mostrar más