Eligibility specialist vs referral specialist

Differences between eligibility specialist and referral specialist duties and responsibilities

Eligibility specialist example responsibilities.

• Manage assignments of paying medical bills limit in depth that include organizing and researching regulations as pertain to veterans eligibility.
• Demonstrate competency in basic understanding of Medicaid, policies, forms and DHS policy.
• Coordinate these efforts by working with DES staff, other state agencies, FEMA and other volunteering private organizations.
• Conduct Medicaid and TANF eligibility interviews.
• Interview patients using multiple data base system to assess and determine Medicaid eligibility coverage for long term care services.
• Experience with disability claim process as DHS eligibility worker desire.
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Referral specialist example responsibilities.

• Manage assignments of paying medical bills limit in depth that include organizing and researching regulations as pertain to veterans eligibility.
• Interview patients, evaluate eligibility, collect co-pays, deductibles, including, but not limit to insurance verification.
• Input HIPAA information, call physician offices to verify testing, collect copay's and deductibles.
• Arrange for debt repayments or establish repayment schedules and send out insurance claims with the correct ICD-9 and CPT codes.
• Research referrals and either deny or approve based on information obtain and appropriately identify diagnosis (CPT and ICD-9 coding).
• Maintain confidentiality by following all applicable HIPAA regulations.
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