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Professional Summary
Ambitious and highly skilled Patient Financial Experience Rep. Motivated and passionate for a Supervisory position in healthcare with an innovative approach. Able to lead all aspects of operations while increasing customers, revenue and staff. Offering 5 plus years of progressive business experience and best business practice. And 10 plus years of Healthcare experience providing clinical, administrative and patient support.
Skills and Highlights
  • MS Office proficient
  • Supervisor/Management experience
  • Insurance billing procedures
  • Industry software applications
  • Performance evaluations
  • Budgeting and forecasting
  • Adept multi-tasker
  • Excellent verbal communication
  • Resourceful and reliable worker
  • Independent judgment and decision making
  • Promotes positive behavior
  • Process improvement
Work History
Patient Financial Experience Department , 01/2018 to Current
Multicare Health System Revenue Cycle Tacoma, Washington
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Adeptly managed a multi-line phone system and pleasantly greeted all patients.
  • Verified patients\' eligibility and claims status with insurance agencies.
  • Identified and resolved patient billing and payment issues.
  • Evaluated patients\' financial status and established appropriate payment plans.
  • Updated patient financial information to guarantee accuracy.
Owner/Director, Current
Little Impressions Childcare Center, LLC Lakewood, WA

  • Recruited, hired, trained and supervised administrative office staff of 12 +employees.
  • Established and developed highly-efficient and dependable administrative team by delivering ongoing coaching and motivation while providing opportunities for career acceleration through achievements.
  • Prepared and distributed payroll for staff of 12direct reports.
  • Processed accounts receivable and accounts payable.
  • Communicated with parents through enrollment, tours, newsletters, conferences and direct personal communication.
  • Resolved staff and parent disputes through constructive problem-solving techniques.
  • Maintained accurate and detailed records, including staff and child files on enrollments, attendance, health and safety, emergency contact information and incident reports.
Lead-Patient Referral Specialist, 09/2005 to 07/2013
CHI Franciscan Health Tacoma, WA
  • Demonstrated ability to lead and motivate outstanding healthcare teams.
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Professionally and courteously verified appointment times with patients.
  • Verified patients' eligibility and claims status with insurance agencies.
  • Determined prior authorizations for medication and outpatient procedures.
  • Assisted in resolving and satisfying client requests and internal operational issues.
  • Established standards for selection, promotion and termination of staff.
  • Led the planning and achievement of goals and objectives consistent with the agency mission and philosophy.
  • Encouraged creative thinking, problem solving, and empowerment as part of the facility management group to improve morale and teamwork.
  • Identified process improvements in the day-to-day functioning of the department.
Education
Associate of Science: ECE, Current
Everett Community College (EvCC) - Everett, WA
Certificate: Medical Assistant, Clover Park Technical College - Lakewood, WA
General studies: Medical Terminology , Pierce College Fort Steilacoom - Lakewood, WA
This resume is created in 7 minutes.
Professional Profile
Dependable Administrative assistant/ referral specialist with 6-year track record of success in medical records management. Focused on delivering exceptional results through strong time management, communication and team work abilities. . Currently seeking a fast-paced positive work environment with the opportunity to grow with the company and enhance my skills.
Qualifications
  • Data entry
  • Administrative support
  • HIPAA compliance
  • Documentation
  • Inventory coordination
  • Patient-focused 
  • Client relations
  • Critical thinking skills
  • Work well independently
  • Professional demeanor
  • Knowledge of HMOs and Medicare
  • ICD-9 coding experience
Experience
Customer Service Advocate II
February 2017 to April 2017
BlueCross Blue Shield Marketplace Columbia, SC
  • Experience with claims and researching rejections and appropriate codes to justify claims
  • Answering member calls and questions regarding policy changes
  • Further assisting members with understanding their coverage
  • Assisting members with payment options as well as any billing questions Answering pharmacy as well as physician phone calls to further assist in filing process for claims.
Referral Specialist
March 2017 to November 2016
Palmetto Health Columbia, SC
  • Completing prior authorizations for procedures
  • Working with 25+ physician offices at a time Maintaining professionalism and confidentiality with patient information
  • Researching multiple claims to ensure insurance coverage
  • Experience with a wide range of insurance companies obtaining a relationship and authorizations for multiple patients
  • Answering patient as well as physician phone calls.
Clerical Staff
November 2014 to August 2015
Drayer Physical Therapy Institute
  • Scheduling patients Answering phones Verifying multiple different kinds of insurance
  • Review of patient records to insure documentation is compliant for suggested charges (specificity, payer requirements, etc.)
  • Trouble shooting of varying nature Assisting physical therapists/PTA's with scheduling and maintenance.
Administrative Assistant
April 2014 to October 2014
Maxim Healthcare
  • Reviewing and completing payroll Scheduling hospice nurses to proper homes Analyzing/improving company revenue1.
  • Scanned incoming documentation.
  • Pulled patient charts for upcoming appointments.
  • Typed medical orders for procedures and laboratory tests.
  • Disseminated information to correct department, individual or outside location.
Clerical Staff
October 2011 to March 2014
Family Medicine Centers of SC
  • Assisted multiple physicians with scheduling Referred patients to the proper specialist recommended by the physician Verifying multiple different kinds of insurance Obtaining proper authorizations for procedures through multiple different insurance companies.
  • Answering phones Electronic medical records transfer and experience.
Education
Associates : business, December 2016 Central Carolina Technical college business
Diploma : May 2009 Lugoff Elgin High School
This resume is created in 7 minutes.
Summary
Pharmacy Technician with over 8 years of experience in customer service, pharmacy and Medicare service. Seeking an opportunity to use my technical skills, creative talents and commitment to excellence in new and innovative ways. 
Certifications and Licenses
CA Board of Pharmacy License #85303  PTCB- Certified Pharmacy Technician 2010

Skills
  • Dedicated Pharmacy Technician with over 8 years of combined experience within customer service/pharmaceutical industry with the skills to drive performance and enhance customer satisfaction. 
  • Expertise in processing, interpreting and filling prescriptions in a retail and mail service setting
  • Proficient in Medicare policies and procedures with a focus on Prior Authorization and Formulary analysis
  • Competency in all types of Referrals: Compound Medication, High Tech Imaging, Medical Oncology, Radiation Therapy, Specialty Drugs 
  • Leadership Ability with teaching experience
Experience
Instructor of Pharmacy Technology/ Career Services Coordinator Aug 2017 to Current
High Desert Medical College Bakersfield, CA Teach students about essential skills and practices in the field. Under general supervision, plan and implement curriculum and educational programs for students within the program. Accurately maintain attendance records in accordance with the Attendance Policy, submit class roster daily, maintain a separate record of attendance and grades. Assist graduates in securing employment in the field. Create resumes and distribute resumes. Supportive roll in career development. 
Referral Specialist Jan 2015 to Aug 2017
Anthem Inc. (Aim Specialty Health) Glendale , CA Responsible for answering incoming calls and processing referrals for High Tech Imaging, Medical Oncology, Radiation Therapy and Specialty Drugs
Senior Pharmacy Technician Aug 2013 to Dec 2014
Optum Rx (UHG) Costa Mesa , CA Processing Authorization requests for medications submitted by healthcare providers via phone and fax. Includes formulary research, entry of clinical data and application of organizational policies and procedures pertinent to Medicare regulations and quality assurance standards. 
Certified Pharmacy Technician (Mail Service) Dec 2009 to Aug 2014
Optum Rx (UHG) Cypress , CA Interpreting and processing prescription requests for mail service fulfillment. Resolving customer concerns and ensuring accurate data entry per performance metrics
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Summary
Driven adjuser trained in all aspects of insurance billing, claims and collections. Employs high-level negotiation skills in resolving claims to the satisfaction of all involved parties. Analytical thinker and innovative problem solver.
Skills
  • Property adjusting
  • Automobile appraisals
  • Sales background
  • Strong interpersonal and communication skills
  • Property claims

  • Workers' compensation claims
  • Self-directed
  • Analytical
  • Decisive
  • Critical thinker
Experience
Referral Specialist 11/2016 Superior Health Plan Austin, Texas
Verified that information in the computer system was up-to-date and accurate.
Successfully established effective systems for record retention by creating database for daily correspondence tracking.
Processed prior authorizations for medical equipment and medical supplies to members.
Verified claim history for medical equipment.
Provider services for prior authorization.
Business Development Coordinator 07/2015 to 11/2016 All American Chevrolet Killeen, Texas Increased monthly sales by 6% by implementing strategies to develop and expand existing customer base.
Identified strategic partnerships and gathered market information to gain a competitive advantage.
Delivered performance updates, quarterly business reviews and planning meetings.
Identified, coordinated and participated in client relationship-building activities and meetings.
Answered customer questions regarding products, prices and availability. 
Tracked departmental output.
Established and maintained effective communication system.
Identified and drove creative solutions for problems.
Back Office Leader 06/2014 to 05/2015 Best Buy Killeen, Texas Coordinated all department functions for team of 42 employees.
Maintained detailed administrative and procedural processes to improve accuracy and efficiency.
Ensured that team member responsibilities were defined and understood.
Established and maintained effective communication system.
Recruited, retained and developed staff.
Coordinated and lead efforts across a large cross-functional team.
Ensured work was accomplished in a safe manner in accordance with established operating procedures and practices.
Explained human resources policies and procedures to all employees.
Answered employee questions during the entrance and exit interview processes.
Managed communication regarding employee orientation and open enrollment for benefits.
Helped training and development staff with all aspects of training coordination.
Car Sales Woman 11/2013 to 04/2014 Auto Max Ford Killeen, Texas Described use and operation of merchandise to customers.
Exceeded targeted sales goals by 12%.
Created strategies to develop and expand existing customer sales, which resulted in a 15% increase in monthly sales.
Shared product knowledge with customers while making personal recommendations.
Demonstrated that customers come first by serving them with a sense of urgency.
Maintained friendly and professional customer interactions.
Verified that all merchandizing standards were maintained on a daily basis.
Inventory Specialist 03/2013 to 11/2013 Wis Inventory Austin, Texas
Count inventory for large Department stores.
Over see inventory counts.
Train new hires of job duties.
Over exceed on all goals and quota's.
Customer Service For Humana Care RightSource 11/2010 to 03/2013 Ageis Communication Killeen, Texas Provided accurate and appropriate information in response to customer inquiries.
Addressed customer service inquiries in a timely and accurate fashion.
Maintained up-to-date records at all times.
Developed effective relationships with all call center departments through clear communication.
Assisted with the development of the call center's operations, quality and training processes.
Led a team of customer service representatives to increase service center profitability.
Education and Training
High School Diploma: General 2009 Killeen High School Killeen, Texas, United States 3.2 GPA
General Studies Central Texas College Killeen, Texas, United States

Coursework in Dental Hygiene
GPA 3.0
All lines - Claims Adjuster License : Insurance 2017 The adjuster School Texas, United States
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Professional Summary
Bilingual Certified Medical Assistant with more than 15 years experience in healthcare. Motivated MA with a highly effective communication style. Efficient worker who demonstrates strong time management and prioritization skills. Level-headed health professional who remains calm and effective in extremely difficult and stressful situations. Strong belief in importance of companionship and support in patient care.
Skills
Check patient in and out
Verify insurance
Medical records
Assist with Banding procedure
Perform pillcam procedure
Clean and sanitize banding scopes
Authorizations and referrals
Marketing Representative Credentialing

Room patient & assist provider with patient flow

Vital Signs/intake process of patients

Maintain exam rooms

Assist in maintaining inventory of room supplies

Pathology accessioning

Bilingual in Spanish

  • CPR/First Aid certified
  • Adaptable
Work History
Medical Assistant/Medical Secretary, 04/2014 to Current
Orlando Epilepsy Center Orlando, Fl
Verification of patient information by interviewing patient, recording medical history and confirming purpose of visit. Prepares patient for examination by performing preliminary physical tests, taking blood pressure, weight, and temperature and reporting patient history summary. Represents physicians by screening incoming telephone calls; recording and transmitting messages; scheduling, receiving, and announcing scheduled patients and visitors; screening unscheduled patients and visitors; arranging referrals to other health care providers; scheduling appointments for consultations, x-rays, lab tests, physical therapy, MRI's, CT scans, etc.
Medical Assistant Referral Specialist 01/2005 to 03/2014
Orlando Gastroenterology Orlando, Fl
Schedule patient procedure with surgical centers. Provide all documents need for authorizations and referrals forprocedure and medications.Traveled to various different offices to assist physicians. Assist with call backs and biopsies.Pathology accessioning, assist with vitals and minor procedures in GI office. Marketing and credentialing.
Medical Assistant 12/2008 to 12/2009
Tree House Pediatrics Orlando, Fl
Perform front and back office duties. Perform lab test such as Strep, Flu, RSV, Cultures, Ear/Eye irrigation, Acuitytesting and injections.
Medical Assistant 10/2006 to 11/2007
Family Physician Group Orlando, Fl

Monitored vital signs, such as blood pressure and pulse.

  • Responded appropriately to the physical, emotional and developmental needs of patients.
Assist Physician in providing quality patient care. Perform back office duties, Assist With Pap testing and minorsurgeries
Education
Associate of Science: Medical Assistant 2005 Florida Metropolitan University - Orlando Florida
Certifications
CPR/BLS Certificate