The last time I mentioned my job, I described it incorrectly. That was what I thought I’d be doing. I’m not disappointed in what I’m actually doing, don’t get me wrong. I’m quite indifferent. I love what I do. Originally, I had said that I would be helping people sign up for the best health insurance for them based on their lifestyle and their financial situation, but that was wrong. I’m not sure where I even got that. Here’s what I really do:

You know when you go to your family doctor and the person at the front desk scans your insurance ID card, you see your doctor, and the doctor refers you to a specialist? Maybe you need an MRI or a CAT scan, or you just need to see a dermatologist about a mole. When you go to the specialist, your appointment sometimes needs to be authorized by your insurance. If it isn’t, sometimes the appointment can’t even be scheduled. And when you get to the specialist, their office needs to know how much to charge you based on what your insurance covers. But if your primary care doctor’s office doesn’t have the most current information, things can get messy.

Here is where we come in. We are referral authorization and insurance eligibility verification service. Hospitals and practices hire us to basically “catch” referrals before they get to the specialist and check that all the information is correct. Much of the process is automated, but what doesn’t get caught by the computer programs (trying hard not to use terms that people who don’t do this wouldn’t understand) that automate the process, I catch and fix, then send to the specialist. Sometimes, like with the main hospital that I work, we receive referrals from the specialist, because they are the ones who hired us. If the information is incorrect, sometimes we have to send the referral back to obtain more information, but sometimes, through some sleuthing, we can figure out what’s wrong ourselves, update it, and send it on its merry way.

The goal that we are working toward is making the healthcare process easier for everyone: family care doctors, patients, specialists, insurance companies; everyone. The quicker that a patient’s appointment and procedure is authorized and their insurance information is verified, the quicker their appointment can be scheduled. The quicker their appointment is scheduled, the more likely they are to even go. 

So. I love my job. We are doing a great thing, and I am surrounded by tons of people who also love their jobs. It’s full of positivity. Plus, there’s free snacks.


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