We are seeking a detail-oriented and highly organized Ancillary Medical Services Referral Analyst to join our team!
In this role, you will manage and coordinate the referral process for ancillary medical services, ensuring that patients receive the appropriate care in a timely and efficient manner. You will work closely with healthcare providers, patients, insurance companies, and internal departments to facilitate the referral process, track authorizations, and resolve issues.
This person will act as a liaison between patients, healthcare providers, insurance companies, and the internal referral team to coordinate and expedite referrals. A strong sense of follow through is required to document, communicate, and keep meticulous records to facilitate the care of our patients.
Requirements
· Education & Experience:
o High school diploma or equivalent required; Bachelor of Science (BS) OR Associate’s degree in healthcare administration or related field preferred.
o Previous experience (1+ years) in healthcare administration, medical billing, coding, or referral management preferred.
o Familiarity with insurance policies, authorization processes, and medical terminology is a plus.
· Skills & Abilities:
o Exceptionally strong communication and interpersonal skills to interact effectively with patients, providers, and insurance companies.
o Excellent organizational and multitasking abilities with attention to detail.
o Proficiency in Microsoft Office 365 (Excel, Word, Outlook)
o Experience with Electronic Health Records (EHR) systems or database management.
o Ability to problem-solve and think critically in high-pressure situations.
o Knowledge of healthcare regulations, insurance requirements, and referral processes.
o Strong time management skills with the ability to handle multiple priorities.
o A team player with a commitment to fostering a collaborative culture.
o Commitment to continuous learning and skill development through ongoing training (minimum of 2 hours per month).
o Adhere to company policies, procedures, and reporting requirements.
Benefits
If you are ready to join a team of professionals dedicated to making a difference and making lives better, please apply today!
Rising Medical Solutions is a national managed care firm that provides medical cost containment and medical care management services to the workers' compensation, auto, liability, and group health markets. Our client base includes insurance carriers, TPAs, self-insured employers, and public-sector and government entities of varying sizes from small to large tier.
Since 1999, our managed care services have positively impacted hundreds of thousands of employee lives and saved billions in total claim costs for payers across the country. Our flagship bill review service and technologies consistently deliver over 60% in national bill review savings, which includes application of fee schedule/UCR rates, network discounts, nurse audits, provider negotiations, and embedded fraud detection capabilities.
However, our solutions portfolio goes far beyond the standard repricing of medical bills. Our integrated programs deliver clinical and cost-saving expertise before, during, and after treatment. Our proprietary VISION™ platform is the industry’s only multi-product, multi-line, single-sign-on, medical management enterprise system. VISION™ provides claims professionals with unprecedented ancillary referral and medical management capabilities across the entire medical care continuum, from early intervention to payment processing. Together with our passionate, mission-driven employees, Rising delivers an unparalleled user experience for those providing, receiving, and paying for medical care.
Rising also directs and publishes the annual Workers’ Compensation Benchmarking Study, a national research program examining the complex forces impacting claims management in workers’ compensation today. The study has become one of the most cited research publications in the industry and has been the subject of numerous articles, webinars, and conference presentations since its 2013 inception.
