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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing patient referrals and prior authorizations while ensuring compliance with insurance guidelines. Proficient in maintaining organized documentation and providing exceptional customer service in a call center environment.
Highest-signal resume keywords
Call Center ExperienceMedical TerminologyPrior AuthorizationE Clinical WorksMicrosoft Office Proficiency
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Data EntryTyping SkillsReferral ManagementInsurance CommunicationDocumentation Accuracy
Soft Skills
Verbal CommunicationWritten CommunicationCustomer Service
Tools & Technologies
Insurance Eligibility DatabaseE Clinical WorksMicrosoft Office
Industry Keywords
Managed CareMedical Insurance PlansPatient File DocumentationConsult Notes
About the role
Key responsibilities & impact- Handle incoming calls efficiently
- Identify patients’ needs, clarify information, submit referrals via insurance portals, fax referrals, and follow up with patients
- Provide courteous customer service to patients regarding referral requests
- Request consult notes from other providers as needed
- Respond to patient inquiries concerning referrals
- Communicate with insurance companies to ensure requests adhere to coverage guidelines
- Track referrals and provide follow-up as needed
- Document referral activities on patient files for future reference
- Maintain accurate and organized patient file documentation
- Process prior authorization for medications, injections, and biologics
Requirements
What you’ll need- High school diploma or equivalent required
- At least 1 year of Call Center Experience
- Experience with Medical Terminology
- Strong verbal and written communication skills; must be able to communicate in a professional and courteous manner
- Proficient in Microsoft Office applications and insurance eligibility database
- Excellent data entry and typing skills
- A minimum of 1-year previous experience for both Prior Authorization and Referrals preferred
- Knowledge of E Clinical Works
- Knowledge of managed care and medical insurance plans
Benefits
Comp & perks- This position is located in our Las Vegas Corporate Office - 8880 W Sunset Rd, Suite 320, Las Vegas NV 89148.