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Referral specialist skills for your resume and career

Updated January 8, 2025

4 min read

Below we've compiled a list of the most critical referral specialist skills. We ranked the top skills for referral specialists based on the percentage of resumes they appeared on. For example, 17.0% of referral specialist resumes contained patients as a skill. Continue reading to find out what skills a referral specialist needs to be successful in the workplace.

15 referral specialist skills for your resume and career

1. Patients

Here's how referral specialists use patients:

Interviewed patients, evaluated eligibility, collected co-pays, deductibles, including, but not limited to insurance verification.
Created and implemented online virtual second opinion program that gave international patients access to Methodist physicians.

2. Customer Service

Customer service is the process of offering assistance to all the current and potential customers -- answering questions, fixing problems, and providing excellent service. The main goal of customer service is to build a strong relationship with the customers so that they keep coming back for more business.

Here's how referral specialists use customer service:

Receive incoming calls, letters and E-mail from military families and provide exemplary customer service via active listening and professional communication.
Develop business relationships, act as a liaison between community/hospital, market hospital programs /services and provide excellent customer service.

3. Medical Terminology

Here's how referral specialists use medical terminology:

Possess knowledge of medical terminology and ability to understand patient charts/diagnosis and medical reports.
Labor intensive, requiring high levels of accuracy, detail and medical terminology.

4. PET

Here's how referral specialists use pet:

Provided clinical information to CT and PET tech's following GDCC protocols.

5. Patient Care

Patient care entails the diagnosis, recovery, and control of sickness as well as the maintenance of physical and emotional well-being through the use of healthcare providers' services. Patient care is described as services provided to patients by health practitioners or non-professionals under guidance.

Here's how referral specialists use patient care:

Assisted in the coordination of patient care by obtaining necessary clinical information from referring providers.
Worked closely with medical and insurance representatives to ensure proper patient care.

6. Data Entry

Data entry means entering data into a company's system with the help of a keyboard. A person responsible for entering data may also be asked to verify the authenticity of the data being entered. A person doing data entry must pay great attention to tiny details.

Here's how referral specialists use data entry:

Assessed and discerned eligibility, data entry, provide information and referral.
Provided data entry and patient referral authorization for medical call center

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7. Primary Care

Here's how referral specialists use primary care:

Assisted patients with referrals to specialists-Obtained insurance authorizations-Called patients regarding appointments-Assisted other office staff-Medical transcription for general office visits and primary care
Assisted clinical staff with relevant participating provider requirements and with locating in-network specialists approved by the primary care provider as necessary.

8. Process Referrals

Here's how referral specialists use process referrals:

Receive and process referrals based on prior authorization protocols for Medicaid insurers.
Process referrals and verify insurances and obtain authorizations if required.

9. Medical Services

Here's how referral specialists use medical services:

Resolved payment denials related to medical services rendered, without prior authorization.
Create authorizations for outpatient and inpatient medical services and durable medical equipment.

10. CPT

CPT is a medical term that stands for Current Procedural Terminology. Whenever a procedure like surgery or diagnosis occurs or some other medical service is rendered to a patient, it is reported to the concerned physician, insurance company, or organization. The aforementioned practice is widely referred to as CPT.

Here's how referral specialists use cpt:

Assisted Providers with denial/approval codes for CPT codes inquired upon and handled Incoming EMR faxes and set up for review for nurses
Researched referrals and either denied or approved based on information obtained and appropriately identified diagnosis (CPT and ICD-9 coding).

11. HIPAA

Here's how referral specialists use hipaa:

Work closely with Utilization Management to ensure submission accuracy and HIPAA compliance.
Complied with HIPAA Privacy and Security Regulations handling patient information.

13. EMR

Here's how referral specialists use emr:

Entered all referrals related data into the EMR, making corrections and/or updating as necessary.
Scan all prior authorization received by mail or via fax in patient's EMR.

14. Patient Referrals

A referral patient is a written instruction from a primary care doctor to see a specialist for a specific medical service. In this case, a health worker at a level of the health system with insufficient resources - medicines, equipment, skills to cope with a clinical condition seeks help from a facility that is better equipped or has other resources to assist or take over the management of patient's case.

Here's how referral specialists use patient referrals:

Performed patient referrals and authorizations by completing and submitting documents and discussing with providers, insurance carriers and patients.
Obtained prior authorizations from insurance companies according to the specific guidelines of each insurance company for patient referrals to specialists

15. Strong Customer Service

Here's how referral specialists use strong customer service:

Provided strong customer service to internal and external employees.

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List of referral specialist skills to add to your resume

The most important skills for a referral specialist resume and required skills for a referral specialist to have include:

Patients
Customer Service
Medical Terminology
PET
Patient Care
Data Entry
Primary Care
Process Referrals
Medical Services
CPT
HIPAA
Social Work
EMR
Patient Referrals
Strong Customer Service
Phone Queues

Inpatient Services
Insurance Verification
Patient Appointments
Schedule Appointments
Excellent Organizational
Phone Calls
Compassion
Inbound Calls
Insurance Coverage
Excellent Interpersonal
Home Health
Community Resources
Mental Health
Medicaid
Computer System
Insurance Eligibility

Insurance Referrals
MRI
Insurance Carriers
Crisis Intervention
ICD-9
Human Services
Medical Necessity
Patient Demographics
Hippa
Outbound Calls
PCP
Social Services
Enters Authorizations
Durable Medical Equipment
Front Desk

Updated January 8, 2025

Zippia Team

Editorial Staff

The Zippia Research Team has spent countless hours reviewing resumes, job postings, and government data to determine what goes into getting a job in each phase of life. Professional writers and data scientists comprise the Zippia Research Team.

Updated January 8, 2025

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