Bon Secours
Referral & Insurance Specialist - Orthopedic Admin
Bon Secours, Cincinnati, Ohio, United States, 45208
Referral & Insurance Specialist - Orthopedic Admin
Join to apply for the Referral & Insurance Specialist - Orthopedic Admin role at Bon Secours.
With a legacy that spans over 150 years, Bon Secours is a network dedicated to providing excellent care through exceptional people. At every level, everyone on our teams has embraced the call to provide compassionate care. Here, you can work with others who share common values, and use your skills to help extend care to all of our communities.
About Us As a faith-based and patient-focused organization, Bon Secours exists to enhance the health and well‑being of all people in mind, body and spirit through exceptional patient care. Success in this goal requires a culture of compassion, collaboration, excellence and respect. Bon Secours seeks people who are committed to our values of compassion, human dignity, integrity, service and stewardship to create an environment where associates want to work and help communities thrive.
Job Summary The Referral and Insurance Specialist obtains authorizations from insurance companies for referrals to physicians and/or procedures testing. The Specialist verifies eligibility/coverage for referral via phone/fax/Internet, schedules appointments for testing at medical facilities or appointments with physicians, gathers charge information, enters all pertinent charge and patient demographic information into the computer billing system, posts all payments and makes daily deposits, assists patients regarding billing questions and account balance resolution, and promotes a positive and helpful climate for good interpersonal and interdepartmental relationships.
Candidates must live in the greater Cincinnati area as occasional on‑site meetings are required.
Essential Functions
Obtains authorizations from insurance companies for referrals to physicians/medical facilities and/or procedures/testing.
Schedules appointments for testing at medical facilities or appointments with physicians.
Verifies eligibility/coverage for referral/testing via phone/fax/Internet.
Investigates billing problems and denials.
Notifies patients of referral process whether authorized or denied in a timely manner. Gives patients instructions.
Performs data input of patient and/or insurance changes and corrections to ensure current and accurate information in billing system.
Answers the telephone, takes messages, schedules appointments and greets patients as needed.
Prepares patient charge encounter forms for each day and makes new or updates patient chart as needed.
Oversees waiting area, coordinates patient movement, and reports problems or irregularities.
Screens visitors and responds to routine requests for information.
Organizes and files progress notes, testing reports, and other forms necessary for chart completion. Assists with appropriate filing of patient charts as needed.
Collects patient responsibility balances and copayments as needed. Balances money collected daily.
Opens and distributes daily mail as needed.
Obtains authorizations from insurance carriers or pharmacy benefit managers for medications.
Collects all daily charge slips from the physician and reconciles the number of charge slips and their totals.
Applies all payments to the appropriate patient account by posting each into the computer billing system.
Inputs all charge information into the online billing system.
Assists with coding and error resolution as well as requesting needed information by working with the physician offices.
Works with patients in resolving billing questions and patient account resolution.
As applicable, reviews information to make determination on the appropriate course of action for the patient, makes referrals to the local DSS office as appropriate.
This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job‑related duties as required by their supervisor, subject to reasonable accommodation.
Education & Qualifications Education:
High School Diploma or GED (required)
Licensure / Certification:
None
Experience 2–3 years of experience in a related medical field with experience in processing referrals (preferred).
What We Offer
Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources and discounts
Paid time off, parental and FMLA leave, short‑and-long‑term disability, backup care for children and elders
Tuition assistance, professional development and continuing education support
Benefits may vary based on the market and employment status.
All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Bon Secours – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are affirmative action and equal opportunity employers, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com.
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With a legacy that spans over 150 years, Bon Secours is a network dedicated to providing excellent care through exceptional people. At every level, everyone on our teams has embraced the call to provide compassionate care. Here, you can work with others who share common values, and use your skills to help extend care to all of our communities.
About Us As a faith-based and patient-focused organization, Bon Secours exists to enhance the health and well‑being of all people in mind, body and spirit through exceptional patient care. Success in this goal requires a culture of compassion, collaboration, excellence and respect. Bon Secours seeks people who are committed to our values of compassion, human dignity, integrity, service and stewardship to create an environment where associates want to work and help communities thrive.
Job Summary The Referral and Insurance Specialist obtains authorizations from insurance companies for referrals to physicians and/or procedures testing. The Specialist verifies eligibility/coverage for referral via phone/fax/Internet, schedules appointments for testing at medical facilities or appointments with physicians, gathers charge information, enters all pertinent charge and patient demographic information into the computer billing system, posts all payments and makes daily deposits, assists patients regarding billing questions and account balance resolution, and promotes a positive and helpful climate for good interpersonal and interdepartmental relationships.
Candidates must live in the greater Cincinnati area as occasional on‑site meetings are required.
Essential Functions
Obtains authorizations from insurance companies for referrals to physicians/medical facilities and/or procedures/testing.
Schedules appointments for testing at medical facilities or appointments with physicians.
Verifies eligibility/coverage for referral/testing via phone/fax/Internet.
Investigates billing problems and denials.
Notifies patients of referral process whether authorized or denied in a timely manner. Gives patients instructions.
Performs data input of patient and/or insurance changes and corrections to ensure current and accurate information in billing system.
Answers the telephone, takes messages, schedules appointments and greets patients as needed.
Prepares patient charge encounter forms for each day and makes new or updates patient chart as needed.
Oversees waiting area, coordinates patient movement, and reports problems or irregularities.
Screens visitors and responds to routine requests for information.
Organizes and files progress notes, testing reports, and other forms necessary for chart completion. Assists with appropriate filing of patient charts as needed.
Collects patient responsibility balances and copayments as needed. Balances money collected daily.
Opens and distributes daily mail as needed.
Obtains authorizations from insurance carriers or pharmacy benefit managers for medications.
Collects all daily charge slips from the physician and reconciles the number of charge slips and their totals.
Applies all payments to the appropriate patient account by posting each into the computer billing system.
Inputs all charge information into the online billing system.
Assists with coding and error resolution as well as requesting needed information by working with the physician offices.
Works with patients in resolving billing questions and patient account resolution.
As applicable, reviews information to make determination on the appropriate course of action for the patient, makes referrals to the local DSS office as appropriate.
This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job‑related duties as required by their supervisor, subject to reasonable accommodation.
Education & Qualifications Education:
High School Diploma or GED (required)
Licensure / Certification:
None
Experience 2–3 years of experience in a related medical field with experience in processing referrals (preferred).
What We Offer
Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources and discounts
Paid time off, parental and FMLA leave, short‑and-long‑term disability, backup care for children and elders
Tuition assistance, professional development and continuing education support
Benefits may vary based on the market and employment status.
All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Bon Secours – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are affirmative action and equal opportunity employers, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com.
#J-18808-Ljbffr