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Health Plan Referral Specialist
Description POSITION SUMMARY: This position is responsible for the coordination of Referral/Precertification Management information between the UM/CM Department and providers via telephone and/or faxed clinical information. This position also performs selected data entry as submitted by medical providers. MAJOR RESPONSIBILITIES: Receive, process and complete data entry of demographic information for all referral and authorization requests from providers via fax or phone and as appropriate, forward to precertification nurse/care manager/case manager. Begin on-line process utilizing skills of typing, medical terminology and ICD/CPT coding.Request, document and forward out of network provider de
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