Clinical Referral Specialist at Mary Rutan Hospital – Bellefontaine, Ohio

The primary responsibility of this role is the coordination of referrals to and from Mary Rutan Health’s practices and clinics to other sites of care. They will contact insurance companies, physicians, and patients to ensure that pre-certification and/or pre-authorization determination can be made for scheduled services, that all necessary documentation is on file to prepare for scheduling and appointments and may help with navigation to the most appropriate provider or care setting. To achieve these responsibilities the duties may include, but are not limited to:

• Act as a liaison between hospitals, clinical staff, health plans, providers, and patients to process referrals.
• Verify insurance coverage and assist with authorizations as needed.
• Gather pertinent information from patients, medical offices, insurance carriers, and other staff.
• Document referrals, communications, actions, and other data in the hospital’s EMR.
• Generate and distribute all applicable forms, notifications, and paperwork.
• Ensure timely response to customer needs, including both internal and external customers.