Clinic Referral Representative – Remote

Fairview Health Services, Saint Paul, MN 55104, Openings : 1, Experience : Not Specified
Job Description :
M Health Fairview has an immediate opening for a Clinic Referral Representative Referral Coordinator to support the M Health Fairview Primary Care Clinics.

This is a 0.6 FTE (48 hours per two week pay period), benefits-eligible opening.

Day shift, Monday – Friday scheduling.

This is an Offsite/Remote role supporting primary care clinics across the system. Orientation and training will take place onsite.
Responsibilities/Job Description:
The Clinic Referral Representative understands and communicates referral requirements of contracted health plans to patients, physicians/authorized practitioners, and coworkers. Review patient referral information to verify consistency with patients’ insurance guidelines and utilization of appropriate networks. Ensures that necessary referrals are successfully transmitted to insurance. Acts as a referral liaison between patients, physicians/authorized practitioners, specialists, and health plan representatives.
  • Directly communicates with and acts as a resource for patients, physicians/authorized practitioners, and specialists regarding managed care insurance contracts and referrals.
  • Completes referral process:
    • Enters referrals into the practice management system and/or health plan internet sites.
    • Edits and updates referrals via appropriate method.
    • Resolves referral transmission errors.
    • Investigates and completes referral authorization inquiries.
  • Documents accurately, clearly, and appropriately in the practice management system, health plan internet sites, and patient medical record.
  • Identifies out of network referral requests and collaborates with physicians/authorized practitioners to redirect when appropriate, to ensure consistency with patients’ insurance benefits and utilization of applicable care systems. Communicates and documents referral denials to patients and third party payors.
  • Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served.


High School Diploma/G.E.D.


None to 1 Year



Vocational/Technical Training or Associate Degree


1 to 3 years prior experience preferred

Prior Epic experience preferred


Must be able to prioritize and work independently.
Previous experience in a health care environment preferred.
Knowledge of third party payors preferred.
Excellent public relations and communication kills.
Strong computer skills.
Must be detail oriented and efficient.
Last Date For Apply: 2022-07-21 05:07:00 Job Type : Full Time, Employment Type : PermanentExpired