Temporary Account Assistant 4 - Referral

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Overview

The Account Assistant 4 assists with department accounts, posts payments, and collects on outstanding accounts. Responsibilities include analyzing clinical documentation, ensuring compliance with coding guidelines, obtaining and managing insurance authorizations, and posting cash and resolving credit balances. The role also involves handling customer service inquiries, authorizations, and administrative tasks to ensure accurate and timely billing and maximum reimbursement. Effective communication with insurance companies, patients, and internal stakeholders is key to resolving billing issues and providing high levels of service and support.

Position Focus:

The Referrals Representative determines contract and benefit eligibility, provides authorization for inpatient admissions, outpatient precertification, prior authorizations and post-service request.  The Referrals Representative conducts the clinical screening process and authorizes initial set of sessions to provider and checks benefits for facility based treatment.  Refers cases requiring clinical review to a Nurse reviewer.  Serves as a principle source of information in order to manage heavy volume of referrals questions and inquiries. 

Required Skills and Abilities

1. Highly motivated, articulate team player with excellent critical thinking skills
     and the ability to use sound independent judgment.   

2. Demonstrated ability in interpreting, applying, communicating, 
     processing and verifying healthcare claims/referrals/insurance eligibility
     criteria.

3.  Excellent time management and organizational skills.  Ability to prioritize work
     in order to meet multiple, competing deadlines.  Strong attention to detail
     and the ability to ensure work is completed accurately and within established
     deadlines. 

4.  Positive and professional interpersonal skills with a strong customer
     service orientation.  Demonstrated ability to manage difficult or sensitive
     issues with tact and diplomacy.

5.  Demonstrated ability to respond to complex inquiries and compose related
     correspondence.  Excellent spelling, grammar, punctuation, attention to detail
     and ability to proofread.

5.   Advanced problem identification and resolution skills.  Ability to understand

      and adhere to established policies, procedures and protocols.

6.   Well-developed communication skills with the ability to initiate and foster

      effective, respectful and appropriate communication.  Works
     effectively and respectfully with a diverse population.

7.  Proficiency in Excel and Word.  Proficiency in clinical systems applications, such as EPIC or similar, with special emphasis relative to external referrals.

8.   Exemplary attendance, punctuality and reliability, as attested by references
 

Preferred Skills and Abilities
Claims adjudication experience, knowledge of Yale Health benefit design; proficiency with Workday and IDX

Principal Responsibilities

1. Serves as a principal source of information on rules and procedures governing University accounts receivable. Oversees and instructs support staff. 2. Oversees maintenance of account files, ensuring accuracy and completeness. Reviews payment histories. 3. Resolves problem and delinquent accounts with supervisor and collection agency. Assists with final review and disposition of problem accounts. 4. Recommends and implements changes to systems and operating procedures. Composes form letters and correspondence used in accounts receivable activities. 5. Researches individual accounts. Summarizes findings in reports. Completes and processes forms. Performs clerical functions incidental to account activity. Required Education and Experience Four years of related work experience, two of them in the same job family at the next lower level, and high school level education; or two years of related work experience and an Associate's degree, or an equivalent combination of experience and education.

Job Posting Date

06/24/2026

Job Category

Administrative Support

Bargaining Unit

NON

Compensation Grade

Labor Grade D

Compensation Grade Pro