FAQs
What is the primary responsibility of a Referral Specialist at Paragon Healthcare?
The primary responsibility of a Referral Specialist is to provide support to a clinical team by facilitating the administrative components of clinical referrals, ensuring smooth communication between various stakeholders.
What kind of experience is required for this position?
A minimum of 1 year of experience in a high-volume, interactive customer service or call center in a healthcare environment is required. Alternatively, a combination of education and experience that provides an equivalent background is acceptable.
What educational qualifications are necessary for this role?
Candidates must have at least a high school diploma or GED to qualify for this position.
What are some specific duties that a Referral Specialist may perform?
Duties include acting as a liaison between hospitals, health plans, physicians, patients, and vendors; reviewing and verifying the completeness of complex referrals; obtaining insurance authorizations; and entering all relevant information into the system.
Is knowledge of medical terminology important for this role?
Yes, knowledge of medical terminology and plan-specific guidelines is preferred, as it aids in effectively processing referrals.
Are there coding skills required for the Referral Specialist position?
While not mandatory, familiarity with ICD-9 and CPT coding is preferred for candidates applying for this position.
How does the Referral Specialist handle referrals?
The Referral Specialist reviews referrals for completeness, assigns them to appropriate staff, verifies insurance coverage, obtains authorizations when necessary, and documents all communications and actions in the system.
In what environments does Paragon Healthcare provide drug therapies?
Paragon Healthcare provides life-saving and life-giving infusible and injectable drug therapies through specialty pharmacies, infusion centers, and at home settings.
What skills or abilities might be beneficial for a Referral Specialist beyond the minimum requirements?
Being a subject matter expert (SME) in various aspects related to referral processes, along with strong communication and organizational skills, would be beneficial for a Referral Specialist.