Patient Referral Specialist

HCA Healthcare • Austin, TX

5d

About The Position

The Patient Referral Specialist at St. David's Cardiology processes physician, hospital, and outpatient referrals. The role coordinates patient scheduling, insurance eligibility and authorizations, and guidance about insurance coverage. It works with diagnostic and surgical service areas, physician offices, hospitals, and payors to ensure referrals and appointments are completed accurately and promptly. This position is eligible for use in practices that see more than 50 patients daily.

Requirements

• High school diploma or GED equivalent.
• At least one year of experience in referral coordination involving insurance provider tier levels, insurance authorizations, and out-of-network procedures.
• Knowledge of medical terminology.
• Knowledge of common safety hazards and precautions for maintaining a safe work environment.
• Ability to establish and maintain effective working relationships with patients, medical staff, and the public.
• Good interpersonal skills.
• Ability to communicate effectively verbally and in writing, while maintaining a positive attitude with patients, peers, providers, employers, insurers, and family members.
• Flexibility and ability to handle multiple tasks.
• Good organizational skills.

Nice To Haves

• Word processing and Excel experience.

Responsibilities

• Coordinate scheduling of patient appointments, tests, and procedures with diagnostic and surgical service areas, physician offices, and hospitals.
• Provide accurate patient demographic and medical information relevant to scheduled appointments to support patient safety and quality care.
• Determine insurance eligibility and authorization for medical office or surgical visits, or coordinate with an authorization coordinator to confirm payor authorizations.
• Initiate the electronic medical record by entering patient demographics, referring and certifying physicians, and family information; obtain needed medical records from referring providers.
• Establish and maintain rapport with office staff, hospital personnel, and managed-care representatives.
• Use the EMR or other designated programs to capture and track referrals.
• Obtain accurate and valid physician or advanced practitioner orders for scheduled appointments, tests, and procedures.
• Communicate appointment, test, procedure, and preparation information accurately to patients or family members.
• Follow privacy, compliance, and HIPAA regulations.
• Ensure patients have follow-up appointments with physicians to discuss outcomes when appropriate.
• Document appointment, test, scan, or procedure dates and times accurately in the patient's medical record.
• Communicate with practice staff as appropriate and ensure the referral process is completed and closed.
• Submit outgoing referrals the same day, preferably while patients are present, to help obtain an optimal appointment.
• Report referral volume, referral status, and follow-up on outstanding appointments to practice leadership weekly.
• Perform related work and adhere to the Code of Conduct and Mission and Value Statements.

Benefits

• Comprehensive medical, prescription drug, dental, vision, behavioral health, and telemedicine benefits.
• Wellbeing support, including free counseling and referral services.
• Paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence.
• 401(k) plan with a 100% match on 3% to 9% of pay, based on years of service.
• Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support, and financial wellbeing counseling.
• Tuition assistance, student loan assistance, certification support, dependent scholarships, and a partnership with Galen College of Nursing.
• Fertility and family-building benefits and adoption assistance.
• Life insurance and supplemental health protection plans.
• Auto and home insurance, legal counseling, identity theft protection, and consumer discounts.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED